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    Spirometry: Dr. Dora Florian

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    Spirometry measures lung function by determining the volume and speed of air inhaled and exhaled using an instrument called a spirometer. It is used to diagnose and monitor lung diseases like asthma and COPD. Key metrics include FEV1, FVC, and their ratio. Obstructive lung diseases reduce airflow while restrictive diseases reduce total lung volume. Spirometry helps differentiate these and assess response to treatment.

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    Spirometry: Dr. Dora Florian

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    Dora
    113 views15 pages
    Spirometry measures lung function by determining the volume and speed of air inhaled and exhaled using an instrument called a spirometer. It is used to diagnose and monitor lung diseases like asthma and COPD. Key metrics include FEV1, FVC, and their ratio. Obstructive lung diseases reduce airflow while restrictive diseases reduce total lung volume. Spirometry helps differentiate these and assess response to treatment.

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    Introduction in spirometry - physiology

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    Spirometry

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    Spirometry measures lung function by determining the volume and speed of air inhaled and exhaled using an instrument called a spirometer. It is used to diagnose and monitor lung diseases like asthma and COPD. Key metrics include FEV1, FVC, and their ratio. Obstructive lung diseases reduce airflow while restrictive diseases reduce total lung volume. Spirometry helps differentiate these and assess response to treatment.

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    Download as pptx, pdf, or txt
    113 views15 pages

    Spirometry: Dr. Dora Florian

    Uploaded by

    Dora
    Spirometry measures lung function by determining the volume and speed of air inhaled and exhaled using an instrument called a spirometer. It is used to diagnose and monitor lung diseases like asthma and COPD. Key metrics include FEV1, FVC, and their ratio. Obstructive lung diseases reduce airflow while restrictive diseases reduce total lung volume. Spirometry helps differentiate these and assess response to treatment.

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    SPIROMETRY

    DR. DORA FLORIAN


    Introduction

     It measures lung function, specifically the volume and or speed (flow) of air that can be
    inhaled and exhaled by a subject
     It is an objective, noninvasive, sensitive to early change and reproducible method
     It is essential for the diagnosis and monitoring of many diseases of the RS
     It is performed with an instrument called “spirometer” in order to:
     detect the presence or absence of a lung disease (asthma, COPD, cystic fibrosis, pulmonary
    fibrosis)
     quantify lung impairment
     monitor the effects of occupational/environmental exposures
     determine the effects of medications
    Spirometer

     Spirometer is an instrument that measures


    and records the volume of inhaled and
    exhaled air, used to assess pulmonary
    function
     The computer connected to spirometer
    converts the signal into numerical values
    and graphical images called a spirogram
    Why do we do it?

     To diagnose or manage asthma


     To measure response to treatment of conditions which spirometry detects
     To dg and differentiate between obstructive lung disease and restrictive lung disease
     To identify those at risk from pulmonary barotrauma while scuba diving
     To conduct pre-op risk assessment bf anesthesia or cardiothoracic surgery
     Health promotion (smoking cessation)
    Contraindications

     Hemoptysis of unknown origin


     Pneumothorax
     Unstable cardiovascular status (angina, recent myocardial infarction, etc.)
     Thoracic, abdominal, or cerebral aneurysms
     Cataracts or recent eye surgery
     Recent thoracic or abdominal surgery
     Nausea, vomiting, or acute illness
     Undiagnosed hypertension
    Patient positioning

     Sit upright: there should be no difference in the amount of air the patient can exhale from
    a sitting position compared to a standing position as long as they are sitting up straight
    and there are no restrictions.
     Feet flat on floor with legs uncrossed: no use of abdominal muscles for leg position.
     Loosen tight-fitting clothing: if clothing is too tight, this can give restrictive pictures on
    spirometry (give lower volumes than are true).
     Dentures normally left in: it is best to have some structure to the mouth area unless
    dentures are very loose.
     Use a chair with arms: when exhaling maximally, patients can become light-headed and
    possibly sway or faint.
    Procedure

     Slow maneuver (VC):


     Quiet breathing
     Full inspiration
     Complete exhalation
     Forced maneuver (FVC):
     Quiet breathing
     Maximal inspiration
     Rapid and complete expiration
     Rapid and deep inspiration
    Static Lung Volume

     tidal volume (TV): the volume of air inhaled


    and exhaled during each breath = 500mL
     Inspiratory reserve volume (IRV): the
    maximum amount of air that can be inspired at
    the end of normal inhalation = 2500 mL
     Expiratory reserve volume (ERV): the
    maximal volume of air that can be exhaled
    from the end-expiratory position = 1500 mL
     Residual volume (RV): the volume of air
    remaining in the lungs after a maximal
    exhalation = 1000-1500 mL
    Lung capacities

     Total lung capacity (TLC): the volume of air


    contained in the lungs at the end of maximal
    inspiration (TLC = TV + IRV + ERE + RV) = 5500-
    6000mL air
     Vital Capacity (VC): the volume of air breathed out
    after the deepest inhalation (VC = TV + IRV + ERV) =
    4500mL
     Inspiratory Capacity (IC): maximum amount of air
    that can be breathed in (IC = TV + IRV) = 3000 Ml
     Functional Residual Capacity (FRC): the volume in
    the lungs at the end-expiratory position (FRC = ERV +
    RV) = 3000mL
    Dynamic lung volumes

     Forced expiratory volume in one second (FEV1): the volume of air exhaled during the
    first second of a forced expiration.
    Percentage of predicted FEV1 value Result
    80% or greater normal
    70%–79% mildly abnormal
    60%–69% moderately abnormal
    50%–59% moderate to severely abnormal
    35%–49% severely abnormal
    Less than 35% very severely abnormal
    Dynamic lung volumes

     Forced vital capcity (FVC): the determination of the vital capacity from a maximally forced
    expiratory effort

    Percentage of predicted FVC value Result


    80% or greater normal
    less than 80% abnormal

     The Tiffneau Index (ratio of FEV1/FVC * 100); NV >= 75%


    Reading spirometry

     ASSESSMENT OF FVC: <80% of the theoretical


    value => restrictive defect
     EVALUATION OF FEV: <80% of the theoretical
    value => obstructive defect
     EVALUATION Tiffeneau INDEX: <70 -75% of
    the absolute value => obstructive deficit
    Restrictive pulmonary disease

     Restrictive disorders -> loss in lung volume:


    pulmonary fibrosis, pleural disease, chest wall
    disorders (kyphoscoliosis), neuromuscular
    disorders, pneumonectomy, pulmonary oedema
    and obesity
     Restriction is characterised by:
     reduced FVC
     normal-to-high FEV1/FVC ratio;
     normal looking shape on spirometry trace
     possibly a relatively high PEF (peak expiratory
    flow: the highest forced expiratory flow measured
    with a peak flow meter)
    Obstructive pulmonary disease

     Obstruction -> airflow limitation => decreased airway calibre (smooth muscle
    contraction, inflammation, mucus plugging or airway collapse in emphysema)
     Eg: COPD, asthma, tumors of the lung/pleura, aspiration of foreign objects
     Obstructive disorders are characterised by:
     reduced FEV1
     normal (or reduced) VC
     normal or reduced FVC
     reduced FEV1/FVC ratio
     concave flow–volume loop

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