Contraindications to spirometry

Relative contraindications to performing spirometry include:

• acute myocardial infarction in the previous week
• history of syncope related to forced expiration or cough
• recent concussion with continuing symptoms
• eye, sinus or middle ear surgery in the previous week
• middle ear infection in the previous week
• current or recent pneumothorax
• thoracic or abdominal surgery in the previous 4 weeks
• current haemoptysis.

For a full list of relative contraindications to spirometry, see the American Thoracic Society and European Respiratory Society technical statement on the standardisation of spirometry, available here.

Also consider infection-control measures in patients with current respiratory infection.

Relative contraindications do not preclude spirometry but should be considered before ordering or performing spirometry to evaluate the risks and benefits of spirometry for the patient.

Patients with contraindications that would prevent testing in the clinic setting may be tested in a respiratory laboratory by an experienced operator with access to emergency care if needed. Potential contraindications should be included in the referral form for spirometry.