Lung India (Jan 2019)

Joint Indian Chest Society-National College of Chest Physicians (India) guidelines for spirometry

  • Ashutosh Nath Aggarwal,
  • Ritesh Agarwal,
  • Sahajal Dhooria,
  • K T Prasad,
  • Inderpaul S Sehgal,
  • Valliappan Muthu,
  • Navneet Singh,
  • D Behera,
  • S K Jindal,
  • Virendra Singh,
  • Rajesh Chawla,
  • J K Samaria,
  • S N Gaur,
  • Anurag Agrawal,
  • S K Chhabra,
  • Vishal Chopra,
  • D J Christopher,
  • Raja Dhar,
  • Aloke G Ghoshal,
  • Randeep Guleria,
  • Ajay Handa,
  • Nirmal K Jain,
  • Ashok K Janmeja,
  • Surya Kant,
  • G C Khilnani,
  • Raj Kumar,
  • Ravindra Mehta,
  • Narayan Mishra,
  • Anant Mohan,
  • P R Mohapatra,
  • Dharmesh Patel,
  • Babu Ram,
  • S K Sharma,
  • Rupak Singla,
  • J C Suri,
  • Rajesh Swarnakar,
  • Deepak Talwar,
  • R Lakshmi Narasimhan,
  • Saurabh Maji,
  • Ankan Bandopadhyay,
  • Nita Basumatary,
  • Arindam Mukherjee,
  • Milind Baldi,
  • Nandkishore Baikunje,
  • Hariprasad Kalpakam,
  • Pratap Upadhya,
  • Rakesh Kodati

DOI
https://doi.org/10.4103/lungindia.lungindia_300_18
Journal volume & issue
Vol. 36, no. 7
pp. 1 – 35

Abstract

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Although a simple and useful pulmonary function test, spirometry remains underutilized in India. The Indian Chest Society and National College of Chest Physicians (India) jointly supported an expert group to provide recommendations for spirometry in India. Based on a scientific grading of available published evidence, as well as other international recommendations, we propose a consensus statement for planning, performing and interpreting spirometry in a systematic manner across all levels of healthcare in India. We stress the use of standard equipment, and the need for quality control, to optimize testing. Important technical requirements for patient selection, and proper conduct of the vital capacity maneuver, are outlined. A brief algorithm to interpret and report spirometric data using minimal and most important variables is presented. The use of statistically valid lower limits of normality during interpretation is emphasized, and a listing of Indian reference equations is provided for this purpose. Other important issues such as peak expiratory flow, bronchodilator reversibility testing, and technician training are also discussed. We hope that this document will improve use of spirometry in a standardized fashion across diverse settings in India.

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