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Pulmonary Function


Indications for (PFT) - presence of lung disease - how much of the lung is damaged - the amount of damage due to the disease - progress of the disease - nature of the disease - evaluate the therapy given - response to therapy
Pulmonary Function Equipment - Spirometer - Electronic Spirometer - Pneumotachometer - Peak Flow Meter
Spirometer are used to MEASURE FLOWS and FLOW RATES
Pneumotachometers measures flow, and volume
Peak Flow Meters - measured at bedside - patient exhale forcefully which moves the indicator - read directly from the device -
Peak Flow Meter Values Low Range: 300-400 L/min Typical: 10L/sec= 600L/min High Range: 600-800 L/min
Peak Flow Meters Personal Best - record peak flow everyday morning and noon for 2-3 weeks when asthma is under control. - should be recorded after (SABA)
Plethysmograph (Body Box) - Boyles Law - Measure Thoracic Volume = FRC ( more accurately) Raw (airway resistance)
Calibration and Quality Control of Equipment must meet ATS-ERS standards tests are done by large volume syringe( Super Syringe) 3.0L Accuracy +/- 3.5% (2.895-3.105) L using flow = 2 and 12 L/sec
To Calibrate Flow use rotameter
Gas Analyzer calibration are calibrated = 0 = running a gas that doesn't contain the gas you are calibrate (i.e. 100% oxygen reads 0 on a He/ N2 analyzer)
Gas Analyzer Troubleshooting Galvanic- fuel cell Polarographic : replace batteries
Pressure Manometer MIP/ MEP MIP= < -20 = inspiratory muscle weakness MEP=< + 40 = poor ability to clear airway secretions
PFT Testing and Procedure (VC)vital capacity,(SVC) slow vital capacity patient is instructed to take a maximal inspiration followed by maximal expiration WITHOUT force
(SVC) Identify slow vital capacity Restrictive look at SVC for restrictive disease DECREASED = RESTRICTIVE
Vital Capacity indicator Vital capacity is the BEST for RESTRICTIVE DISEASE INDICATOR
Forced Vital Capacity The volume of air that can be expired as forcefully and as rapidly as possible after a max inspiration
Forced Vital Capacity Identify Identifies= FLOW RATES OBSTRUCTION
Forced Vital Capacity maneuver and procedure will provide important FLOW RATES to identify OBSTRUCTIVE DISEASES
Flows that can be measured FEV 1.0 FEF 200-1200 FEF 25-75 PEFR
FEV 1.0 The amount of gas expired in the 1st sec A decrease indicates OBSTRUCTIVE
FEV/FVC Value given as a ratio
Decreased FEV/FVC 1.0 The BEST indicator of OBSTRUCTIVE DISEASE
Measurements and Minimum Accepted FEV/FVC fev 0.5 = 60% fev 1.0 = 70% fev 2.0 = 94% fev 3.0 = 97%
FVC The FVC is not a FLOW its a VOLUME
MVV The largest volume and rate that can be breathe per minute voluntary effort performed for 12-15 secs
Pre and Post Bronchodilator Testing used to measure reversibility of an obstructive pattern Minimum increased 12% and 200mL All bronchodilators should be held 8 hours prior to test
FRC measures RV, TLC
FRC can be measured by He dilution N2 was out (Open method) Plethysmograph (Body Box) (closed)
DLCO measures carbon monoxide NV = 25mL CO/min/mmHg/ (STPD)
Decreased DLCO All restrictive + Except Emphysema The only Obstructive
Flow Volume Loops A normal flow volume loop should look like a football
Flow Volume Loop Obstructive short and wide = Obstructive
Flow Volume Loop Restrictive skinny and tall
Predicted Normal Values All measured values are compared with the predicted normal values for that individual. Based on Age, Height, Gender
Important Evaluation look at the % predicted
Classification of Interpretation Normal = 80-100% Mild = 60- 79% Moderate = 40 - 59% Severe = < 40%
Obstructive Disease CBABE Cystic Fibrosis, Bronchitis, Asthma, Bronchiectasis, Emphysema
Restrictive EVERYBODY ELSE e.g. neuromuscular, pleural disease, thoracic deformities
Created by: sukarieh