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PFT 01

Spirometry

QuestionAnswer
Primary uses of PFT quanitify changes in fxn and impairment. 2. screening of disease 3. assessment of post op 4. determination of pulm disability 5. evaluation of therapy effectiveness
Basic pt types who are unable to do PFT severe hypoxemia on room air 2. increased intracranial pressure 3. cardiac arrhythmias 4. inability to follow directions (age, disease) 5. untreatable TV or HIV
Tidal volume VT amount of air moved in and out of lungs during normal breathing
Inspiratory reserve volume (IRV) amount of air inspired from normal inspiration
Expiratory reserve volume (ERV) amount of air exhaled from normal exhalation
Residual volume (RV) amount of air left in the lungs after maximum exhalation
inspiratory capacity (IC) amount of air inspired from normal expiration
Functional residual capacity (FRC) amount of air left in the lungs after normal exhalation
vital capacity (VC) amount of air exhaled in one breath; the max amount of air that can be forcibly exhaled after breathing in as much as possible (max inhalation)
Total Lung capacity (TLC) amount of air in the lungs after max inhalation
Info you need to get before testing Gender, age, height, weight, race, exposure to chemicals, history of medicine, current symptoms, pack years of smoking
Volumes and capacities that CAN be measured with simple spirometry 1 Slow vital capacity (called enhanced spirometry) 2. FVC 3. Max voluntary ventilation
Forced expiratory volume 1 sec how much air pt can blow out in one second after they have taken a max breath
forced expiratory volume 3 sec how much air pt can blow out in 3 sec after they have taken a max breath
Forced expiratory flow 200-1200 mL machine disregards the first 200 ml that the pt exhales after max inhalation and then measures how fast the pt exhales the next 1000 mL (LARGE UPPER AIRWAY)
forced exp flow 25%-75% machine disregards the first 25% and the last 25% of the air that the pt exhales after max inhalation and then measures how fast the pt exhales (SMALL AIRWAY obstruction)
Maximum voluntary ventilation largest volume and rate that can be breathed per minute, in and out as fast as possible for 12-15 seconds (REPRESENTS STRENGTH OF RESP MUSCLES)
PfTs are measured at ATPS
PFTS are reported at BTPS
Pt's who are candidates for methacholine challenge asthma, fireman, assess severe of hyper responsiveness, to determine relative risk of developing asthma, to asses response to therapy
How is methacholine delivered dosimeter- only on inspiration and only 5 breaths of each dose level 25 mg/ml
Substances that can be used for bronchoprovacation testing histamine - 10 mg/ml 2. antigens 6-8mm wheel 3. cold air 4. exercise
Avoid short acting bronch 6-8 hours
avoid long acting bronch 48 hr
avoid anticholinergic aerosols 24 hr
avoid tiotropium up to 1 week
avoid disodium cromglycate 8 hr
avoid nedocromil 48 hr
avoid oral beta 2 adrenergic agonist 24 hr
avoid theophyllines 12-24 hr
avoid leukotriene modifiers 24 hr
Pt that is candidate for exercise study Dyspnea with exertion where past tests are normal.2 asthma and being athletic, 3. known exercise induced asthma
AVERAGE tidal volume Ve/f
ATS criteria for PFT testing Spirometer must be 8 liters, must be capable of measuring 0-14 L/s, all tests reported by BTPS, min of 3 acceptable FVC 8 max, FVC must be .2 L (150 ml) of each other
Acceptable PFT meets end of criteria, no coughing during 1st second inhalation, no closing of glottis, no leak, no obstruction of mouthpiece opening
Created by: TnJFarrington12