Illustration of lungs, bronchiectasis, and complex mazes

Decoding Bronchiectasis: Beyond the Standard Spirometry Test

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Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"Unlocking a Comprehensive Understanding of Lung Function and Targeted Treatment Strategies"


Bronchiectasis, characterized by damaged and dilated bronchi, leads to recurring respiratory symptoms. While traditionally viewed as a chronic obstructive disease, the reality is far more intricate. Simple spirometry, measuring how much air you can exhale in one second (FEV1), often falls short in capturing the full picture of lung function in these patients.

International guidelines often recommend basic spirometry, but recent research suggests that bronchiectasis patients can exhibit a range of lung function abnormalities beyond simple airflow obstruction. These include restrictive patterns, air trapping (where air gets stuck in the lungs), and even seemingly normal lung function in some cases. Relying solely on spirometry can miss crucial aspects of the disease.

A comprehensive approach is needed to fully understand bronchiectasis. Researchers have investigated lung function in bronchiectasis patients using advanced techniques, aiming to identify specific functional subgroups and improve treatment strategies. This article will delve into the complexities of lung function in bronchiectasis, exploring the importance of advanced testing and personalized approaches to care.

What Does Comprehensive Lung Function Testing Reveal?

Illustration of lungs, bronchiectasis, and complex mazes

Researchers conducted a multi-center study involving 187 adult bronchiectasis patients, performing detailed lung function tests beyond standard spirometry. These tests included body plethysmography (measuring lung volumes and airway resistance) before and after bronchodilator use, and diffusing lung capacity (DLCO, assessing how well oxygen passes from the lungs into the bloodstream).

The study revealed that relying solely on spirometry would have missed significant abnormalities in many patients. Key findings included:

  • Air trapping was highly prevalent, affecting 70.2% of patients.
  • Impaired DLCO was also common, observed in 55.7% of patients.
  • Airflow obstruction, the focus of spirometry, was present in only 41.1% of patients.
  • A small percentage of patients (9.7%) had completely normal lung function based on all tests.
  • Reversibility of air trapping (improvement after bronchodilator) was more frequent than reversibility of airflow obstruction.
These findings highlight that bronchiectasis affects the lungs in diverse ways. Air trapping and diffusion impairment were more common than airflow obstruction, challenging the traditional view of bronchiectasis as solely an obstructive disease. Some individuals with air trapping experienced improvements after using bronchodilators, which had better lung function and might have a better prognosis.

Taking a Comprehensive Approach to Bronchiectasis Care

The research emphasizes that bronchiectasis is a complex condition with varied effects on lung function. Simple spirometry alone is insufficient to capture the full spectrum of abnormalities.

A comprehensive assessment, including plethysmography and DLCO testing, can reveal hidden issues like air trapping and diffusion impairment, potentially leading to more targeted treatment strategies. For instance, identifying patients with reversible air trapping may allow clinicians to tailor bronchodilator therapy more effectively.

Further research is needed to determine the optimal approach to managing bronchiectasis based on comprehensive lung function assessment. However, this study underscores the importance of moving beyond simple spirometry to improve diagnosis and personalize treatment plans for individuals with this complex respiratory condition.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

1

Why is simple spirometry often insufficient for bronchiectasis patients?

Bronchiectasis is characterized by damaged and dilated bronchi, leading to recurring respiratory symptoms. While simple spirometry focuses on airflow obstruction by measuring FEV1 (how much air you can exhale in one second), it often fails to capture the complete picture of lung function in bronchiectasis patients. Advanced testing is needed to understand other potential abnormalities.

2

What does comprehensive lung function testing for bronchiectasis involve, beyond standard spirometry?

Comprehensive lung function testing for bronchiectasis includes techniques beyond simple spirometry, such as body plethysmography (measuring lung volumes and airway resistance) and diffusing lung capacity (DLCO, which assesses how well oxygen passes from the lungs into the bloodstream). Body plethysmography helps detect air trapping, while DLCO identifies diffusion impairments.

3

What were the key findings of the multi-center study regarding lung function abnormalities in bronchiectasis patients?

A multi-center study revealed that many bronchiectasis patients have abnormalities missed by spirometry alone. Air trapping was highly prevalent (70.2%), as was impaired DLCO (55.7%). Airflow obstruction, the focus of spirometry, was present in only 41.1% of patients. A small percentage (9.7%) had completely normal lung function based on all tests.

4

What does air trapping mean in the context of bronchiectasis, and why is it important?

Air trapping in bronchiectasis means that air gets stuck in the lungs, preventing efficient gas exchange. The study found that air trapping was more prevalent than airflow obstruction. What’s important is that some individuals with air trapping experienced improvements after using bronchodilators. This is more frequent than reversibility of airflow obstruction, and those with better reversibility might have a better prognosis.

5

What are the implications of relying solely on spirometry for managing bronchiectasis, and how can a comprehensive approach lead to more personalized treatment?

The reliance on simple spirometry overlooks abnormalities like air trapping and impaired DLCO, which are common in bronchiectasis. Identifying these issues can help doctors select targeted treatments such as mucoactive agents (to clear mucus), airway clearance techniques and pulmonary rehabilitation. It can also help understand which patients may benefit from bronchodilators, even if they don't present with airflow obstruction.

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