Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2020
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2021
    • 2020 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Top 10 Papers in 2020
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • Call for Abstracts 2021
    • 2020 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Follow aarc on Twitter
  • Visit aarc on Facebook
Research ArticleOriginal Research

Inspiratory Flow-Volume Curve Evaluation for Detecting Upper Airway Disease

James B Sterner, Michael J Morris, Joshua M Sill and Jackie A Hayes
Respiratory Care April 2009, 54 (4) 461-466;
James B Sterner
Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael J Morris
Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
Joshua M Sill
Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jackie A Hayes
Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

BACKGROUND: The 2005 American Thoracic Society/European Respiratory Society guidelines on spirometry emphasize examination of the inspiratory curve of the flow-volume loop for evidence of intrathoracic or extrathoracic upper airway obstruction. We sought to determine how frequently evaluations are performed for abnormal inspiratory curves.

METHODS: We retrospectively reviewed all examinations performed in our pulmonary function testing laboratory over a 12-month period (n= 2,662). In patients with normal spirometry or a mild restrictive defect, we inspected the inspiratory curves for truncation, flattening, or absent loop. With patients who had an abnormal inspiratory curve, we examined 3 flow-volume loops to determine if more than one loop showed an inspiratory abnormality, and to assess changes in the mid-flow ratio (ratio of forced expiratory flow at 50% of the forced expiratory volume to forced inspiratory flow at 50% of the forced inspiratory volume), and we used the loop that had the best inspiratory and expiratory curves. We reviewed the medical records for underlying disease processes and evidence of upper airway evaluation.

RESULTS: One hundred twenty-three patients (4.6%) had an abnormal inspiratory curve. Sixty-nine (56%) of those 123 patients had inspiratory abnormalities on > 2 flow-volume loops. Evaluation of the inspiratory abnormality was undertaken in only 17% of all patients, and 30% of patients who had consistently abnormal inspiratory curves. A specific etiology was identified in 52% of the evaluated patients. Vocal cord dysfunction was the most frequent diagnosis. Utilizing the loop that had the combination of the best inspiratory and expiratory curves decreased the mid-flow ratio from 3.07 ± 1.63 to 1.77 ± 1.15.

CONCLUSIONS: An abnormal inspiratory curve in the presence of otherwise normal spirometry should prompt an evaluation for the etiology. If one of the flow-volume inspiratory curves shows an abnormality, all the inspiratory curves from that PFT session should be reviewed, and if more than one inspiratory curves is abnormal, both anatomical and functional evaluation should be undertaken for intrathoracic and extrathoracic upper airway obstruction.

  • inspiratory curve
  • upper airway obstruction
  • pulmonary function testing

Footnotes

  • Correspondence: Michael J Morris MD COL MC USA, Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston TX 78234-6200. Email: michael.morris{at}amedd.army.mil.
  • Copyright © 2009 by Daedalus Enterprises Inc.
PreviousNext
Back to top

In this issue

Respiratory Care: 54 (4)
Respiratory Care
Vol. 54, Issue 4
1 Apr 2009
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Inspiratory Flow-Volume Curve Evaluation for Detecting Upper Airway Disease
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Inspiratory Flow-Volume Curve Evaluation for Detecting Upper Airway Disease
James B Sterner, Michael J Morris, Joshua M Sill, Jackie A Hayes
Respiratory Care Apr 2009, 54 (4) 461-466;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Inspiratory Flow-Volume Curve Evaluation for Detecting Upper Airway Disease
James B Sterner, Michael J Morris, Joshua M Sill, Jackie A Hayes
Respiratory Care Apr 2009, 54 (4) 461-466;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • inspiratory curve
  • upper airway obstruction
  • pulmonary function testing

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About Us
  • Editorial Board
  • Reprints/Permissions

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire