PulmApps

Pulmonary-specific clinical tools for the busy clinician

Spiro Maker

Spirometry

Pattern:
Normal
Obstructive
Restrictive
Mixed
Uninterpretable
Isolated reduction in FEV1

Severity (ATS/ERS 2005):
Mild (>70%)
Moderate (60-69%)
Moderately Severe (50-59%)
Severe (35-49%)
Very Severe (<35%)

Severity (ATS/ERS 2022):
Mild (z-score -1.65 to -2.5)
Moderate (z-score -2.51 to -4)
Severe (z-score <-4)

Bronchodilator Response:
Not Performed
Positive BDR (≥10% in pred. value)
Positive BDR (both ≥12% and 200mL)
Borderline BDR (either ≥12% or 200mL)
Negative BDR (<10% in pred. value)
Negative BDR (neither ≥12% or 200mL)
Negative but normalized

Flow-Volume Loop:
Deferred
Normal
Restricted
Scooped
Variable EXTRAthoracic Obst. (e.g. VCD)
Variable INTRAthoracic Obst. vs. Effort
Fixed Airway Obstruction
Artifact vs Poor Effort vs Weakness

Reduced Midflows (FEF25-75)

Use Z-scores (ATS 2022)

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Lung Volumes

Not Performed
No restriction / normal
True restriction (Low TLC) without air trapping
True restriction with air trapping
Pseudorestriction / Occult Air trapping
Elevated TLC with air trapping (Hyperinflation)
Low ERV, IC:ERV > 6: Obesity effect

Plethysmography N2 Washout

Diffusion Capacity

Not Performed
Normal
Mild (>60%)
Moderate (40-59%)
Severe (20-39%)
Very Severe (<20%)
Uninterpretable
High (>120%)

DLCO/VA (KCO):
Low (<80%)
Borderline Low (80-100%)
Normal (100-120%)
High (>120%)

Low VA(<80%) Normal VA(>80%)

Adjust for Hgb:

Hgb(g/dL):

DLCO(%pred):

Mouth Pressures

MIP(cwp):

MEP(cwp):

SNIP(cwp):

Demographics:

Male Female

Age:

Fractional Exhaled Nitric Oxide

Low (Less than 25 ppb)
Indeterminate (25 to 50 ppb)
High (Higher than 50 ppb)

Interpretation

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This clinical tool is designed to facilitate report generation for Pulmonary Function Testing and suggest differential diagnoses and does not replace clinical judgement.

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