Table 3

Summary of contraindications and the main reason to avoid testing

ContraindicationReason to avoid lung function testing*Recommendation
Thoracic/abdominal surgeryRupture site of injury, avoid pain, discomfortRelative
Brain, eye, ear, ENT surgeryRupture site of injury, avoid pain, discomfortRelative
PneumothoraxWorsen pneumothorax, avoid discomfort and painRelative
Myocardial infarctionInduce further infarction leading to cardiac arrestAbsolute/relative
Ascending aortic aneurysmRupture of aneurysm, catastrophic/fatal eventAbsolute/relative
HaemoptysisPulmonary emboli or myocardial infarctionRelative
Pulmonary embolismDeath, hypoxia leading to respiratory failureAbsolute/relative
Acute diarrhoeaDiscomfort, embarrassment, infection riskRelative
AnginaMay lead to cardiac arrest in severe cases. discomfortAbsolute/relative
Severe hypertension (systolic >200 mm Hg, diastolic >120 mm Hg)Risk of blackout/collapse, rupture of cerebral blood vessels, etc.Measure blood pressure before tests if suspected
Confused/demented patientsLung function tests are volitional and need patient cooperationBalance need for test against difficult in obtaining results
Patient discomfortVomiting, diarrhoea, cold sores, common coldWait until main symptoms abate
Infection control issueContagious infections (norovirus, tuberculosis, flu)Wait until main symptoms abate

  • ↵* Sometimes the risk may be necessary as a preoperative assessment for life-saving surgery.

  • Recommendation: absolute, lung function testing should be avoided in most cases; relative, judge each case on its merits.