ATS Criteria

Question 1

ATS Criteria Regarding Spirometers

Answer 1

• Must measure at least 8L of volume and flows between 0-14L/sec
• Must accumulate volume for 15 sec.
• Accuracy must be within +/- 3.5% or 65 mls
• Less than 1.5 cm/H2O/L/sec resistance with flows between 0-14 L/sec

Question 2

ATS Criteria Regarding Records

Answer 2

• Paper records or graphic display mandatory

- Displays must be stored and retrievable

Question 3

ATS Criteria for VC

Answer 3

• Volume plateau on max. inspiration and max. expiration
• Minimum of 3 tests performed
• 2 largest and acceptable VCs are within 150 mls of each other

Question 4

ATS Criteria for FVC maneuvers

Answer 4

• No hesitation or coughing at the beginning of the forced exhalation
• Minimum exhalation time 6 secs. for adults (with a 1 sec. plateau) or until there is no change in volume for 1 sec.
• Maximum exhalation time 12-15 sec.
• Minimum number of trials = 3, maximum of 8
• 2/3 largest FVC’s must be within 150 mls of each other
• 2/3 largest FEV1 must be within 150 mls of each other
• BEV less than 150 mls or less than 5% of FVC
• PEFs on the 3 trials should be within 10% of each other (indicates effort in consistant)

Question 5

ATS Criteria Regarding Values Reported for Spirometry

Answer 5

• Largest FVC
• Largest FEV1
• FEV1/FVC% based on value derived from above FEV1 and FVC
• Largest PEFR
• Largest PIFR
• All other flow rates are taken from best curve (best curve=largest sum of FVC+FEV1)

Question 6

ATS Criteria Regarding Reversibility

Answer 6

• When FEV1 or FVC changes by greater than 12% + 200 mls

Question 7

ATS Criteria Regarding MIP/MEPs

Answer 7

• Best of 3 MEPs/MIPs recorded (values must be within 10% or 10 cm H2O)

Question 8

ATS Criteria for FRCpleth

Answer 8

• Minimum of 3 FRC measurements
• FRCpleth variability should be within +/- 5% (At least 3 FRCs)
• FRCpleth reported = average value
• Panting Frequency = 30-60 pants/min

Question 9

ATS Criteria for FRC (He)

Answer 9

• He concentration should be stable prior to the beginning of test
• Test continued until He concentration changes less that 0.02% in 30 sec.
• Time required for test should be reported (normal time = 3-4 minutes but less than 10)
• If multiple trials are performed they must be within 10% and average value reported

Question 10

ATS Criterai for FRC (N2)

Answer 10

• No leaks during test ( greater than 1% change or increase in expiratory N2%)
• time between tests is 15 minutes
• At least one technically satisfactory test or if more than one measurment made, then mean mean value is reported
• N2 washout complete if N2 concentration is less than 1.5% for 3 successive breaths

Question 11

ATS Criteria for Raw

Answer 11

• Minimum of 3 Raw measurements
• Raw values must be within 5% of each other
• Average Raw reported

Question 12

ATS Criteria for DLco

Answer 12

• Patient condition (no smoking for 24 hours; D/C O2 at least 10 mins prior to test; patient sitting at least 5 min prior to test)
• Inspriratory maneuver: smooth, rapid and complete inhalation (85% of best VC should be reached within 4 sec)
• Breath hold time and expiration: As close to TLC as possible for 10 +/- 2. Exhalation time less than 4 sec. Breath hold should be a relaxed effort
• Washout (0.75-1.0L) and sample volume (0.5-1.0L) depends on patients VC
• Reported DLco: Average of 2 acceptable tests (4 min between), acceptable within 10% or 3ml/min/mmHg)
• Recommends that DLco predicted equation be adjusted for Hbg concentration COHb% and PAO2