Spirometry is the most fundamental and widely used test for the functional assessment of breathing. It is a simple, non-invasive method that allows for the objective evaluation of pulmonary function and constitutes an integral tool in clinical pulmonology, primary health care, and preventive medicine.
Historical Overview
The history of spirometry dates back to the mid-19th century. In 1846, John Hutchinson constructed the first spirometer and introduced the term Vital Capacity (VC). Through his observations, he was the first to demonstrate the correlation between lung capacity and overall health, as well as perioperative mortality, laying the foundations for the clinical application of the test.
During the 20th century, spirometry evolved significantly with the introduction of new parameters, such as the Forced Expiratory Volume in one second (FEV₁) and the Forced Vital Capacity (FVC). The transition from mechanical to electronic and digital spirometers greatly improved the accuracy, reproducibility, and usability of the examination.
Today, spirometry is governed by international guidelines (ATS/ERS), which ensure standardization, reliability, and comparability of results. At the same time, the development of portable devices has made spirometry widely accessible even outside specialized pulmonary laboratories.
Clinical Significance of Spirometry
The clinical importance of spirometry is crucial both for the diagnosis and monitoring of respiratory diseases. It is the primary method for distinguishing between obstructive and restrictive respiratory disorders, allowing for early and well-documented diagnosis.
In obstructive diseases, spirometry is essential for the diagnosis and staging of Chronic Obstructive Pulmonary Disease (COPD), as well as for the diagnosis and follow-up of asthma. Furthermore, it contributes to the evaluation of bronchiectasis, small airway obstructive disorders, and post-infectious bronchial damage.
In restrictive diseases, spirometric findings support the diagnosis of interstitial lung diseases, such as idiopathic pulmonary fibrosis, pulmonary fibrosis of other etiologies, thoracic deformities (e.g. scoliosis, kyphoscoliosis), neuromuscular diseases, and disorders of the chest wall.
Additionally, spirometry is used:
- In preoperative assessment of respiratory risk
- In occupational medicine for the evaluation of exposure to inhaled pollutants
- In the investigation of dyspnea of unknown etiology
- In monitoring response to pharmacological treatment, particularly after bronchodilator testing
- FEV₁ has been shown to be not only an indicator of respiratory function but also a strong prognostic marker of overall mortality and cardiopulmonary risk
- In the early prediction of COPD development at very early stages
Simplicity and Accessibility of the Examination
One of the most significant advantages of spirometry is its ease of application. It is a non-invasive, painless examination, usually lasting less than fifteen minutes, with low cost and immediate availability of results.
The test is a fundamental and inseparable part of pulmonologist training, requires good cooperation from the examined individual, and can be reliably performed in various settings, such as outpatient clinics, hospitals, health centers, and primary care units. The widespread use of portable spirometers has further strengthened the role of spirometry in preventive screening, particularly among smokers and high-risk individuals.
Conclusion
Spirometry is a cornerstone of functional respiratory assessment. Its historical development, proven diagnostic and prognostic value, and ease of application make it an indispensable tool in modern medical practice. Proper and systematic use contributes decisively to early diagnosis, appropriate management, and improvement of quality of life in patients with respiratory diseases, while it can also be applied to any healthy individual as part of preventive evaluation of pulmonary function (e.g. athletic activities, occupational exposure, routine respiratory check-up).
The above examination, along with the benefits it entails, is performed at Euromedica Egkefalos Chalandriou, in a fully organized and modern environment, using reliable equipment and in accordance with ATS/ERS guidelines. Results are available within minutes, allowing prompt assessment of pulmonary function by a specialist pulmonologist and immediate clinical guidance for the examined individual.
Alexandros Alexopoulos, MD Consultant Pulmonologist
Scientific Director, Pulmonology Department Euromedica Egkefalos Chalandriou