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Usefulness of the forced expiratory volume in six seconds (FEV6) as an alternative for the forced vital capacity (FVC) in spirometry

Tuesday, 19 June, 2007 - 17:00
Campus: Brussels Health Campus
Faculty: Medicine and Pharmacy
auditorium R. Vanden Driessche
Jan Vandevoorde
phd defence

Spirometry, and in particular the forced
expiratory manoeuvre, is the most widely used
lung function test, and is an invaluable tool in
assessing respiratory disease. For the
interpretation of spirometry, the commonly used
diagnostic parameters are the forced vital
capacity (FVC), the forced expiratory volume in
one second (FEV1) and the FEV1/FVC ratio.
However, spirometry is an effort-dependent test
that requires full patient cooperation. Especially
the effort to exhale completely, in order to obtain
FVC, can be particularly demanding for some
patients, resulting in the inability to perform
acceptable and repeatable manoeuvres.

Moreover, spirometry is increasingly used by
primary care physicians, enhancing the need for
easy-to-perform spirometric manoeuvres.
This thesis focuses on the introduction of a
shorter, fixed time duration of the forced
expiratory manoeuvre, and evaluates the role of
the forced expiratory volume in six seconds
(FEV6) as an alternative for FVC. We investigated
whether the same diagnosis can be made when
using the FEV1/FEV6 ratio instead of the FEV1/FVC
ratio for the detection of airway obstruction, and
when using FEV6 instead of FVC for the detection
of a spirometric restrictive pattern. In addition,
new fixed cut-off points were determined for use
with FEV1/FEV6 and FEV6. Finally, gender-specific
algorithms were developed that define patient
groups for which spirometry (FVC or FEV6) can
reliably predict a reduced total lung capacity.
These algorithms could help clinicians,
particularly in primary care, to decide whether
lung volume measurements are necessary for the
detection of a restrictive ventilatory defect.