Diagnosis and follow-up of lung diseases can be improved by measuring carbon dioxide and flow under normal breathing, so-called volumetric capnography. With volumetric capnography differences can be discovered in the small respiratory tracts which are the first to be affected in cases of chronic obstructive pulmonary disease, COPD. Spirometry is insusceptible to this and in addition requires active involvement by the patient. It can take a while for the patient to learn the technique. This is not required for volumetric capnography. Spirometry is therefore inadequate in the evaluation of COPD and complementary methods are too complex and expensive from outside specialist caregivers. COPD is often treated wholly within primary care, without complementary examinations. To measure the average EFFi, obtained when doing volumetric capnography, seems to be a good alternative in many areas other than COPD, e.g. to follow cystic fibrosis in children who cannot manage spirometry.
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