Advances in pulmonary laboratory testing

This review examines emerging technologies that are of potential use in the routine clinical pulmonary laboratory. These technologies include the foll owing: the measurement of exercise tidal flow-volume (FV) loops plotted wit hin the maximal FV envelope for assessment of ventilatory constraint during exercise; the use of negative expiratory pressures to asses expiratory flo w limitation in various populations and under various conditions; the poten tial use of expired nitric oxide for assessing airway inflammation; and the use of forced oscillation for assessment of airway resistance. These metho dologies have been used extensively in the research setting and are gaining increasing popularity and clinical application due to the availability of commercially available, simplified, and automated systems. An overview of e ach technique, its potential advantages and limitations will be discussed, along with suggestions for further investigation that is considered necessa ry prior to extensive clinical use.