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Advances in Pulmonary Laboratory Testing^*

^* From the Department of Internal Medicine (Drs. Johnson and Beck), Mayo Clinic and Foundation, Rochester, MN; and the Department of Clinical Investigation (Drs. Zeballos and Weisman), William Beaumont Army Medical Center, El Paso, TX.

Correspondence to: Bruce D. Johnson, PhD, Cardiovascular Health Clinic 200 First St, SW, Mayo Clinic and Foundation, Rochester, MN 55905; e-mail: johnson.bruce{at}mayo.edu

Abstract

This review examines emerging technologies that are of potential use in the routine clinical pulmonary laboratory. These technologies include the following: the measurement of exercise tidal flow-volume (FV) loops plotted within the maximal FV envelope for assessment of ventilatory constraint during exercise; the use of negative expiratory pressures to asses expiratory flow limitation in various populations and under various conditions; the potential use of expired nitric oxide for assessing airway inflammation; and the use of forced oscillation for assessment of airway resistance. These methodologies have been used extensively in the research setting and are gaining increasing popularity and clinical application due to the availability of commercially available, simplified, and automated systems. An overview of each technique, its potential advantages and limitations will be discussed, along with suggestions for further investigation that is considered necessary prior to extensive clinical use.

Key Words: flow-volume • forced oscillation • negative expiratory pressure • nitric oxide

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