How long do we stop SABA or LABA prior to spirometry - Dr. Sheetu Singh

1
Spirometry
Predicted Pre Post Reversibility
FVC 4.1L 3.4 L 3.5L
FEV1 3.4L 1.8L (53) 2.2L 400ml (22)
FEV1/FVC 53
Diagnosis
2
How long do we stop SABA or LABA prior to
spirometry?
3
Role of other ancillary investigations

• Bronchial provocation
• Allergy tests
• FENO

• Helps in phenotyping asthma
• Predicts response to ICS
• FeNO guided therapies have been said to bring
  down the exacerbation rate

4
Differential diagnosis

• Upper airway obstruction
• Tracheal obstruction
• Hyperventilation syndrome
• Panic attack
• COPD
• Bronchiectasis
• Cystic fibrosis
• Mitral stenosis
• Cardiac failure
• Parenchymal lung disease

5
Asthma with no improvement

• 45 Y M F/C Asthma with increase in symptoms since
  2 months
• Symptoms more in night
• Not responding to triple regime of LAMA, LABA and
  ICS
• On examination decreased air entry
• SpO2 95 RA