Table 3

Timing of referral

Cystic fibrosisFEV1 <30% pred
PCO2 >50 mmHg
PO2 <55 mmHg
Rapid decline in FEV1
Clinical deterioration
 Frequent hospitalisation
 Massive haemoptysis
 Recurrent pneumothoraces
 Wasting
Young females with rapid deterioration
Pulmonary fibrosisFailure to maintain lung function  while being treated with  steroids/immunosuppressive agents
Resting hypoxaemia
Pulmonary hypertension
DL,CO <40% pred
HRCT score >2.25
EmphysemaFEV1 <20% pred
PCO2 >6.0 kPa
Homogeneous distribution
Pulmonary hypertension
Pulmonary hypertensionFunctional status
 NYHA class III or IV
 Low exercise tolerance (SMWD   <350 m)
 Uncontrolled syncope, haemoptysis   or right heart failure
Useful haemodynamic variables
 Cardiac index <2 L·min−1·m−2
 Right atrial pressure >15 mmHg
 Sv,O2 <60%
  • FEV1: forced expiratory volume in one second

  • PCO2: carbon dioxide tension

  • PO2: oxygen tension

  • DL,CO: diffusing capacity of carbon monoxide

  • HRCT: high-resolution computed tomography

  • NYHA: New York Heart Association

  • SMWD: 6‐min walking distance

  • Sv,O2: venous saturation