The volitional effort performing spirometry as well as the duration of the expiratory time will increase intra-thoracic, intra-abdominal and intra-cranial pressures
Evidence suggests that performed correctly spirometry should not lead to any adverse complications such as a cardiac event, syncope or pneumothorax.
However, exacerbating pre-existing conditions such as unhealed wounds and aneurysms should not be dismissed. It should also not be assumed that contraindications have been assessed by the referrer.
Always check these contraindications with the patient before commencing with the test. Using a predefined protocol or checklist and utilising appropriate clinical judgement you should avoid potential harm.
The list below outlines some of the established contraindications to performing spirometry. However, to make a more informed decision consider reading the article linked to the research icon at the bottom of your screen.
Current recommendations indicate absolute (don’t do it!) contraindications and relative (take a clinical judgement!) contraindications
Active infection e.g AFB positive TB until treated for 2 weeks
Conditions which may cause serious complications if aggravated by volitional expiration, for example:
Suspected respiratory infection (within the last 4-6weeks)
Undiagnosed chest symptoms e.g haemoptysis
If patient is too unwell to perform the manoeuvre
Communication problems such as learning disability or confusion
A condition which may be aggravated by volitional manoeuvres, for example
The paper below, by Dr. Brendan Cooper, examines the contraindications to performing spirometry in greater detail.
The article reviews the evidence base for the contraindications to performing spirometry and, where it is lacking, the known facts around the potential problems that may arise.
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