Spirometry
Spirometry has the possibility of causing aerosolization, so special
consideration needs to be made (McGowan, A et al Recommendation from ERS
Group 9.1 (Respiratory function technologists /Scientists-Lung function
testing during COVID-19 pandemic and beyond).
The European Respiratory Society (ERS) does not recommend any patients
with symptoms of COVID-19 or flu-like symptoms are tested with
spirometry or Lung Function Tests (LFTs) under any circumstances at this
time. They recommend postponing all routine testing during the pandemic
phase. COVID-19 patients must not be tested for a minimum of 30 days
post-infection.
Full operation of lung function services may only resume when viral
prevalence is low and reliable testing based on a combination of symptom
screening, and testing is readily available.
In the interim period, ERS is recommended only for critical need and if
these mitigation strategies can be implemented
A test should always be carried out with a high specification disposable
in-line bacterial and viral
filter in place with minimum proven efficiency for the high expiratory
flow of 600 to 700 L/min.
The use of disposable combined mouthpieces/sensors is not recommended at
this time. Maximize the use of single-use consumables and dispose of the
items with care e.g., nose clips, rubber mouthpieces, etc.
For highest risk patients requiring essential testing, lung function
should be carried out in a negative pressure room and using equipment
only for high risk or infected patients.
This may only be available at specialist centers.
We recommend the use of either FFP3 masks or FFP2, where the former is
not available. The
duration of the use of protective masks should comply with local policy.
Eye protection must always be worn e.g., goggles or face shields.
Disposable gloves should be used at all times when testing. These should
be discarded afterward.
Exercise testing, nebulization, bronchial challenge tests, and other
aerosol-generating
procedures should be postponed during the pandemic until the green phase
is reached.