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PFT Interpretation Algorithm

FEV1
RV

Normal

Obstructive
(Decreased FEV1/FVC <70%)
Mild

Moderate

Severe

>75

75-60

60-40

<40

80-120
120-150
150-175
Reversible if FEV1 or FVC increase by more than 15% with Bronchodilator Inhalation
Irreversible if No Chnage with Bronchodialtor Inhalation

>200

Normal

Restrictive
(Decreased TLC or FVC <80%)
Mild

Moderate

Severe

TLC or FVC

>80

80-60

60-50

<50

FEV1

>75

>75

>75

>75

RV

120-80
120-80
80-70
70
It's Parenchymal in origin if DLCO is decreased-like Interstitial Lung diseases
It's Extraparenchymal in origin if DLCO is normal -Think of Neuromusclular disorders/Skeletal as Kyphoscoliosis/Obesity/Pleural
effusion and Heavy Ascites
Pulmonary Embolism/Pulmonary Hypertension
Normal PFTs+Decreased DLCO

Pulmonary Function Values


Forced vital capacity (FVC). This measures the amount of air you can exhale with force after you inhale as deeply as possible.
Forced expiratory volume (FEV1). This measures the amount of air you can exhale with force in one breath. The amount of air you exhale

may be measured at 1 second (FEV1), 2 seconds (FEV2), or 3 seconds (FEV3). FEV1 divided by FVC can also be determined.
Forced expiratory flow 25% to 75%. This measures the air flow halfway through an exhale.
Peak expiratory flow (PEF). This measures how quickly you can exhale. It is usually measured at the same time as your forced vital capacity
(FVC).
Total lung capacity (TLC). This measures the amount of air in your lungs after you inhale as deeply as possible.
Functional residual capacity (FRC). This measures the amount of air in your lungs at the end of a normal exhaled breath.
Residual volume (RV). This measures the amount of air in your lungs after you have exhaled completely. It can be done by breathing in helium
or nitrogen gas and seeing how much is exhaled.

Expiratory reserve volume (ERV). This measures the difference between the amount of air in your lungs after a normal exhale
(FRC) and the amount after you exhale with force (RV).

Pulmonary Function Values(Obstructive vs Restrictive)


Lung function test

Restrictive

Obstructive

Forced vital capacity (FVC)

Lower than predicted value

Normal or lower than predicted value

Forced expiratory volume (FEV1)

Normal or lower

Lower

FEV1/FVC

Normal or higher

Lower

Forced expiratory flow 25% to 75%

Normal or lower

Lower

Peak expiratory flow (PEF)

Normal or lower

Lower

Maximum voluntary ventilation (MVV)

Normal or lower

Lower

Total lung capacity (TLC) (VT)

Lower

Normal or higher

Functional residual capacity (FRC)

Normal or lower

Higher

Residual volume (RV)

Normal, lower, or higher

Higher

Expiratory reserve volume (ERV)

Normal or lower

Normal or lower

FEV1

FVC

FEV/FVC

TLC

RV

DLCO

Asthma

Decreased More
than FVC

Decreased

Decreased

Increased

Increased

Normal

Emphysema

Decreased

Decreased

Decreased

Increased

Increased

Decreased(due to
destruction of
Alveolar wall)

COPD

Decreased

Decreased

Decreased

Increased

Increased

Normal if
underlying cause
is Bronchitis and
Decreased in
Emphysema

Interstitial Lung
Disease

Decreased

Decreased

Normal/Elevated

Decreased

Decreased

Decreased(Normal
in
Extraparenchymal
causes)

Pulmonary
Embolism

Normal

Normal

Normal

Normal

Normal

Decreased