PFT Interpretation and Reference Values
|
|
- Warren Blake
- 5 years ago
- Views:
Transcription
1 PFT Interpretation and Reference Values September 21, 2018 Eric Wong
2 Objectives Understand the components of PFT Interpretation of PFT Clinical Patterns How to choose Reference Values
3
4 3 Components Spirometry Flow Lung Volumes Capacity Diffusing Capacity Gas Exchange
5 Distribution of TLC by population:
6 PFT Interpretation (Pellegrino et al., 2005)
7 Spirometry
8 Flow FLOW-VOLUME LOOP VOLUME-TIME CURVE Peak Flow RV E Volume Volume I TLC FRC RV Tidal Breathing TLC Time
9 Flow Forced Expired Flow E Volume Definitions: PEF Peak expiratory flow FVC forced vital capacity FEV1 Forced expiratory volume in 1 sec FEF 25-75% - Mean forced expiratory flow between 25% and 75% of FVC FEF 75% - Forced expiratory flow at 75% FVC I
10 Flow THE FLOW-VOLUME LOOP IN PATIENTS WITH SMALL AIRWAY OBSTRUCTION Palv Pst E Volume Palv Pst I
11 Flow THE FLOW-VOLUME LOOP IN PATIENTS WITH EMPHYSEMA & AIRWAY OBSTRUCTION Palv Pst E Volume Palv Pst I
12 Flow THE FLOW-VOLUME LOOP IN PATIENTS WITH A FIXED EXTRATHORACIC OBSTRUCTION Palv Pst E Volume I
13 Flow THE FLOW-VOLUME LOOP IN PATIENTS WITH A VARIABLE EXTRATHORACIC OBSTRUCTION Floppy Segment P = 0 Palv Pst E Volume Forced Inspiration = (-) Forced Expiration = (+) I
14 Flow AIRWAY REVERSIBILITY E Volume I Criteria for Reversibility: > 12% and 200ml change in FEV1 or FVC Pre test Medication? If test is to determine reversibility No short-acting beta agonist within 4hrs, no long-acting within 12hr prior If test is to determine whether patient s lung function is improving w/ therapy, then patient can continue use of medication prior
15
16
17
18
19 LUNG VOLUMES
20 MEASURING LUNG VOLUMES Gas dilution: 1. Nitrogen washout 2. Helium dilution IRV VT IC VC Body plethysmography ERV RV FRC TLC
21 C 1 V 1 = C 2 V 2 Trapped Air Ventilated Lung Dilution methods measure only the ventilated lung volume, but the Body box method measures all gas in the lungs (trapped air + ventilated lung)
22 THE LUNG VOLUME PATTERNS SEEN WITH INCREASING AIRWAY OBSTRUCTION Normal Very Severe Moderate Severe Slight ERV VC TLC FRC RV Normal TLC Normal FRC Normal RV Zero Volume
23
24 DIFFUSING CAPACITY
25 DIFFUSING CAPACITY Carbon monoxide is used to measure diffusing capacity because CO is usually not present in the blood and CO is diffusion-limited. DLCO =. VCO P A CO - PcCO. VCO P A CO. The units are: ml/min VCO for each mm Hg difference between P A CO and PcCO. PcCO is usually 0, therefore: DLCO =. VCO P A CO PcCO
26 Diffusing capacity is dependent on: DLCO (V A )(Pulmonary Cap Blood Volume)([Hb]) (Alveolar-capillary membrane thickness)([cohb]) DLCO/V A seems to be a way to eliminate the effects of V A but this is not a perfect correction.
27 D L CO (% value at normal TLC) D L CO/V A (% value at normal TLC) EFFECTS OF LUNG VOLUME ON DLCO and DLCO/V A D L CO/V A overcorrects when V A is low D L CO D L CO/V A Alveolar Volume (% Predicted TLC)
28 PFT Diffusion Capacity Pure airway disease asthma, chronic bronchitis normal Restrictive Disease with normal lung parenchyma and pulmonary vasculature Neuromuscular disease, obesity Low DLCO DLCO / VA normal to high
29 PFT Diffusion Capacity Low DLCO Alveolar disease emphysema, alveolitis, pulm edema Thickened Interstitium Pulm fibrosis Pulmonary vascular disease Pulm hypertension Anemia High carboxyhemoglobin just after smoking, CO poisoning Low cardiac output cardiogenic shock
30 DLCO
31 PFT Interpretation
32 PFT Interpretation (Pellegrino et al., 2005)
33 Spirometry
34 INTERPRETING PFTs Spirometry Is FVC normal? >LLN Is there evidence for airway obstruction? FEV1/VC < LLN - more sensitive than FEV1/FVC to detect obstruction - FVC more dependent on flow - take largest of VC, FVC, Slow VC, Insp VC Is there any change after bronchodilator? FEV 1 or FVC >12% and 200 ml (Adapted from Pellegrino et al., 2005)
35
36 Global Strategy for Diagnosis, Management and Prevention of COPD Classification of Severity of Airflow Limitation in COPD* In patients with FEV 1 /FVC < 0.70: GOLD 1: Mild GOLD 2: Moderate GOLD 3: Severe GOLD 4: Very Severe FEV 1 > 80% predicted 50% < FEV 1 < 80% predicted 30% < FEV 1 < 50% predicted FEV 1 < 30% predicted *Based on Post-Bronchodilator FEV Global Initiative for Chronic Obstructive Lung Disease
37 Classification of Severity (Pellegrino et al., 2005) For obstruction FEV1/VC previously determined to be <LLN
38 Lung Volumes
39 Lung Volumes Is there evidence for a restrictive defect? TLC < LLN Are the lungs hyperinflated? TLC > ULN Is there a high RV or FRC? RV or FRC > ULN Is there evidence for air trapping? RV / TLC > ULN
40 Diffusing Capacity
41 Diffusing Capacity Are DLCO or DLCO / VA decreased? < LLN Are DLCO or DLCO / VA increased? > ULN (Pellegrino et al., 2005)
42 Patterns
43 THE LUNG VOLUME PATTERNS SEEN WITH INCREASING AIRWAY OBSTRUCTION Normal Very Severe Moderate Severe Slight ERV VC TLC FRC RV Normal TLC Normal FRC Normal RV Zero Volume
44 LUNG VOLUME PATTERNS SEEN IN PATIENTS WITH AIRWAY OBSTRUCTION Degree of Obstruction TLC VC FRC RV/TLC RV Slight Moderate Severe Very Severe N N N N N N N N N N N
45 LUNG VOLUME PATTERNS SEEN IN PATIENTS WITH RESTRICTIVE DISEASE Causes of Restriction TLC VC FRC RV/TLC RV Obesity Chest wall mechanics Parenchyma Pleural space disease Weak chest muscles N N N N N N N N N N N
46 TYPICAL LUNG FUNCTION PATTERNS Abnormality FEV 1 FVC VC TLC RV RV TLC FRC DLCO Asthma N N N Chronic Bronchitis N N Emphysema N Pulmonary Fibrosis N N N Chest wall or Obesity N N N N N N Muscle Weakness N N N
47 PFT Interpretation (Pellegrino et al., 2005)
48 PFT Interpretation Algorithm Legend PV pulmonary vascular CW chest wall NM neuromuscular ILD interstitial lung diseases CB chronic bronchitis
49
50 Reference Values
51 Ideal Reference Values Find healthy people and do PFT on them Based on the results, develop equations Test equations on other normal and patients with diseases
52 Realistic Approach Find reference set best fit to your population Adopt their standard deviation if your population has similar distribution Use one equation if possible to fit full age range
53 Global Lung Function Initiative From European Respiratory Societ Clinical Research Group Submission of lung function results from > 70 groups
54 GLI 2012 Spirometry reference set 2017 DLCO reference set? Lung Volumes reference set
55 Reference Sets Canadian Thoracic Society Spirometry Lung volumes & DLCO GLI NHANES GLI Gutierrez / Peds Gutierrez / Peds
56 Summary ATS approach to PFT interpretation Poor quality test can lead to misdiagnosis Reference Values awaiting GLI
Teacher : Dorota Marczuk Krynicka, MD., PhD. Coll. Anatomicum, Święcicki Street no. 6, Dept. of Physiology
Title: Spirometry Teacher : Dorota Marczuk Krynicka, MD., PhD. Coll. Anatomicum, Święcicki Street no. 6, Dept. of Physiology I. Measurements of Ventilation Spirometry A. Pulmonary Volumes 1. The tidal
More informationPULMONARY FUNCTION TESTING. Purposes of Pulmonary Tests. General Categories of Lung Diseases. Types of PF Tests
PULMONARY FUNCTION TESTING Wyka Chapter 13 Various AARC Clinical Practice Guidelines Purposes of Pulmonary Tests Is lung disease present? If so, is it reversible? If so, what type of lung disease is present?
More informationBasic approach to PFT interpretation. Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic
Basic approach to PFT interpretation Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic Disclosures Received honorarium from Astra Zeneca for education presentations Tasked Asked
More informationWhat do pulmonary function tests tell you?
Pulmonary Function Testing Michael Wert, MD Assistant Professor Clinical Department of Internal Medicine Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical
More information6- Lung Volumes and Pulmonary Function Tests
6- Lung Volumes and Pulmonary Function Tests s (PFTs) are noninvasive diagnostic tests that provide measurable feedback about the function of the lungs. By assessing lung volumes, capacities, rates of
More informationCoexistence of confirmed obstruction in spirometry and restriction in body plethysmography, e.g.: COPD + pulmonary fibrosis
Volumes: IRV inspiratory reserve volume Vt tidal volume ERV expiratory reserve volume RV residual volume Marcin Grabicki Department of Pulmonology, Allergology and Respiratory Oncology Poznań University
More informationPULMONARY FUNCTION TESTS
Chapter 4 PULMONARY FUNCTION TESTS M.G.Rajanandh, Department of Pharmacy Practice, SRM College of Pharmacy, SRM University. OBJECTIVES Review basic pulmonary anatomy and physiology. Understand the reasons
More informationPulmonary Function Testing The Basics of Interpretation
Pulmonary Function Testing The Basics of Interpretation Jennifer Hale, M.D. Valley Baptist Family Practice Residency Objectives Identify the components of PFTs Describe the indications Develop a stepwise
More informationPulmonary Function Testing: Concepts and Clinical Applications. Potential Conflict Of Interest. Objectives. Rationale: Why Test?
Pulmonary Function Testing: Concepts and Clinical Applications David M Systrom, MD Potential Conflict Of Interest Nothing to disclose pertinent to this presentation BRIGHAM AND WOMEN S HOSPITAL Harvard
More informationInterpreting pulmonary function tests: Recognize the pattern, and the diagnosis will follow
REVIEW FEYROUZ AL-ASHKAR, MD Department of General Internal Medicine, The Cleveland Clinic REENA MEHRA, MD Department of Pulmonary and Critical Care Medicine, University Hospitals, Cleveland PETER J. MAZZONE,
More informationPULMONARY FUNCTION TEST(PFT)
PULMONARY FUNCTION TEST(PFT) Objectives: By the end of the present lab, students should be able to: 1. Record lung volumes and capacities and compare them with those of a typical person of the same gender,
More informationSpirometry. Obstruction. By Helen Grim M.S. RRT. loop will have concave appearance. Flows decreased consistent with degree of obstruction.
1 2 Spirometry By Helen Grim M.S. RRT 3 4 Obstruction loop will have concave appearance. Flows decreased consistent with degree of obstruction. Volumes may be normal, but can decrease with severity of
More informationThe role of lung function testing in the assessment of and treatment of: AIRWAYS DISEASE
The role of lung function testing in the assessment of and treatment of: AIRWAYS DISEASE RHYS JEFFERIES ARTP education Learning Objectives Examine the clinical features of airways disease to distinguish
More informationSPIROMETRY. Marijke Currie (CRFS) Care Medical Ltd Phone: Copyright CARE Medical ltd
SPIROMETRY Marijke Currie (CRFS) Care Medical Ltd Phone: 0800 333 808 Email: sales@caremed.co.nz What is spirometry Spirometry is a physiological test that measures the volume of air an individual can
More informationLung Pathophysiology & PFTs
Interpretation of Pulmonary Function Tests (PFTs) Course # 1612 2:00 5:00pm Friday February 22, 2013 Lung Pathophysiology & PFTs Mark F. Sands MD, FCCP, FAAAAI Division of Allergy, Immunology & Rheumatology
More informationChapter 3. Pulmonary Function Study Assessments. Mosby items and derived items 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 3 Pulmonary Function Study Assessments 1 Introduction Pulmonary function studies are used to: Evaluate pulmonary causes of dyspnea Differentiate between obstructive and restrictive pulmonary disorders
More informationLung Function Basics of Diagnosis of Obstructive, Restrictive and Mixed Defects
Lung Function Basics of Diagnosis of Obstructive, Restrictive and Mixed Defects Use of GOLD and ATS Criteria Connie Paladenech, RRT, RCP, FAARC Benefits and Limitations of Pulmonary Function Testing Benefits
More informationPulmonary Function Testing. Ramez Sunna MD, FCCP
Pulmonary Function Testing Ramez Sunna MD, FCCP Lecture Overview General Introduction Indications and Uses Technical aspects Interpretation Patterns of Abnormalities When to perform a PFT 1. Evaluation
More informationA Primer on Reading Pulmonary Function Tests. Joshua Benditt, M.D.
A Primer on Reading Pulmonary Function Tests Joshua Benditt, M.D. What Are Pulmonary Function Tests Used For? Pulmonary function testing provides a method for objectively assessing the function of the
More informationPulmonary Function Testing
In the Clinic Pulmonary Function Testing Hawa Edriss MD, Gilbert Berdine MD The term PFT encompasses three different measures of lung function: spirometry, lung volumes, and diffusion capacity. In this
More informationPulmonary Function Testing
Pulmonary Function Testing Let s catch our breath Eddie Needham, MD, FAAFP Program Director Emory Family Medicine Residency Program Learning Objectives The Astute Learner will: Become familiar with indications
More informationRESPIRATORY PHYSIOLOGY Pre-Lab Guide
RESPIRATORY PHYSIOLOGY Pre-Lab Guide NOTE: A very useful Study Guide! This Pre-lab guide takes you through the important concepts that where discussed in the lab videos. There will be some conceptual questions
More informationPulmonary Function Tests. Mohammad Babai M.D Occupational Medicine Specialist
Pulmonary Function Tests Mohammad Babai M.D Occupational Medicine Specialist www.drbabai.com Pulmonary Function Tests Pulmonary Function Tests: Spirometry Peak-Flow metry Bronchoprovocation Tests Body
More informationContent Indica c tion Lung v olumes e & Lung Indica c tions i n c paci c ties
Spirometry Content Indication Indications in occupational medicine Contraindications Confounding factors Complications Type of spirometer Lung volumes & Lung capacities Spirometric values Hygiene &
More informationClinical pulmonary physiology. How to report lung function tests
Clinical pulmonary physiology or How to report lung function tests Lung function testing A brief history Why measure? What can you measure? Interpretation/ reporting Examples and case histories Exercise
More informationPULMONARY FUNCTION. VOLUMES AND CAPACITIES
PULMONARY FUNCTION. VOLUMES AND CAPACITIES The volume of air a person inhales (inspires) and exhales (expires) can be measured with a spirometer (spiro = breath, meter = to measure). A bell spirometer
More informationAssessment of the Lung in Primary Care
Assessment of the Lung in Primary Care Andrew G Veale FRACP Auckland, New Zealand Presentation Cough (productive or dry) Haemoptysis Shortness of breath / dyspnea Wheeze (or noisy breathing) Chest pain
More informationExercise 7: Respiratory System Mechanics: Activity 1: Measuring Respiratory Volumes and Calculating Capacities Lab Report
Exercise 7: Respiratory System Mechanics: Activity 1: Measuring Respiratory Volumes and Calculating Capacities Lab Report Pre-lab Quiz Results You scored 100% by answering 5 out of 5 questions correctly.
More informationPhysiology lab (RS) First : Spirometry. ** Objectives :-
Physiology lab (RS) ** Objectives :- 1. Spirometry in general. 2. Spirogram (volumes and capacities). 3. The importance of vital capacity in diagnosis. 4. Flow volume loop. 5. Miss Arwa s part (the practical
More informationVariation in lung with normal, quiet breathing. Minimal lung volume (residual volume) at maximum deflation. Total lung capacity at maximum inflation
r Total lung capacity at maximum inflation Variation in lung with normal, quiet breathing Volume of lungs at end of normal inspiration (average 2,200 ml) Minimal lung volume (residual volume) at maximum
More informationSpirometry: an essential clinical measurement
Shortness of breath THEME Spirometry: an essential clinical measurement BACKGROUND Respiratory disease is common and amenable to early detection and management in the primary care setting. Spirometric
More informationUnderstanding the Basics of Spirometry It s not just about yelling blow
Understanding the Basics of Spirometry It s not just about yelling blow Carl D. Mottram, RRT RPFT FAARC Technical Director - Pulmonary Function Labs and Rehabilitation Associate Professor of Medicine -
More informationLab 4: Respiratory Physiology and Pathophysiology
Lab 4: Respiratory Physiology and Pathophysiology This exercise is completed as an in class activity and including the time for the PhysioEx 9.0 demonstration this activity requires ~ 1 hour to complete
More informationPulmonary Function Manual
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Scholarly Papers 1985 Pulmonary Function Manual John P. Simelaro Philadelphia College of Osteopathic Medicine, johns@pcom.edu Follow
More informationObjectives. Pulmonary Assessment 12/13/2017
Pulmonary Assessment Reid Blackwelder, MD, FAAFP Professor and Chair, Family Medicine Quillen Colege of Medicine, ETSU Objectives Understand anatomy and physiology of pulmonary assessment techniques Remember
More informationPulmonary Function Test
Spirometry: Introduction Dr. Badri Paudel GMC Spirometry Pulmonary Function Test! Spirometry is a method of assessing lung function by measuring the volume of air the patient can expel from the lungs after
More informationS P I R O M E T R Y. Objectives. Objectives 2/5/2019
S P I R O M E T R Y Dewey Hahlbohm, PA-C, AE-C Objectives To understand the uses and importance of spirometry testing To perform spirometry testing including reversibility testing To identify normal and
More informationLecture Notes. Chapter 4: Chronic Obstructive Pulmonary Disease (COPD)
Lecture Notes Chapter 4: Chronic Obstructive Pulmonary Disease (COPD) Objectives Define COPD Estimate incidence of COPD in the US Define factors associated with onset of COPD Describe the clinical features
More informationRespiratory Physiology In-Lab Guide
Respiratory Physiology In-Lab Guide Read Me Study Guide Check Your Knowledge, before the Practical: 1. Understand the relationship between volume and pressure. Understand the three respiratory pressures
More informationThe role of Pulmonary function Testing In Interstitial lung disease in infants. [ ipft in child ]
The role of Pulmonary function Testing In Interstitial lung disease in infants [ ipft in child ] Introduction Managing infants with diffuse lung disease (DLD) suspected to have interstitial lung disease
More informationAnyone who smokes and/or has shortness of breath and sputum production could have COPD
COPD DIAGNOSIS AND MANAGEMENT CHECKLIST Anyone who smokes and/or has shortness of breath and sputum production could have COPD Confirm Diagnosis Presence and history of symptoms: Shortness of breath Cough
More informationRespiratory Pathophysiology Cases Linda Costanzo Ph.D.
Respiratory Pathophysiology Cases Linda Costanzo Ph.D. I. Case of Pulmonary Fibrosis Susan was diagnosed 3 years ago with diffuse interstitial pulmonary fibrosis. She tries to continue normal activities,
More informationQuestion by Question (QXQ) Instructions for the Pulmonary Diagnosis Form (PLD)
Question by Question (QXQ) Instructions for the Pulmonary Diagnosis Form (PLD) A Pulmonary Diagnosis Form is filled out by the reviewer for all medical records that are sent to them for review by the CSCC.
More informationPULMONARY FUNCTION TESTING. By: Gh. Pouryaghoub. MD Center for Research on Occupational Diseases (CROD) Tehran University of Medical Sciences (TUMS)
PULMONARY FUNCTION TESTING By: Gh. Pouryaghoub. MD Center for Research on Occupational Diseases (CROD) Tehran University of Medical Sciences (TUMS) PULMONARY FUNCTION TESTS CATEGORIES Spirometry Lung volumes
More informationPulmonary Func-on Tes-ng. Chapter 8
Pulmonary Func-on Tes-ng Chapter 8 Pulmonary Func-on Tes-ng Which of the following is the true pulmonary func-on test? Spirometry Lung volumes Diffusion capacity ABG Pulmonary Func-on Tes-ng Process of
More informationARF, Mechaical Ventilation and PFTs: ACOI Board Review 2018
ARF, Mechaical Ventilation and PFTs: ACOI Board Review 2018 Thomas F. Morley, DO, FACOI, FCCP, FAASM Professor of Medicine Chairman Department of Internal Medicine Director of the Division of Pulmonary,
More informationSpirometry in primary care
Spirometry in primary care Wednesday 13 th July 2016 Dr Rukhsana Hussain What is spirometry? A method of assessing lung function Measures volume of air a patient can expel after a full inspiration Recorded
More information-SQA-SCOTTISH QUALIFICATIONS AUTHORITY. Hanover House 24 Douglas Street GLASGOW G2 7NQ NATIONAL CERTIFICATE MODULE DESCRIPTOR
-SQA-SCOTTISH QUALIFICATIONS AUTHORITY Hanover House 24 Douglas Street GLASGOW G2 7NQ NATIONAL CERTIFICATE MODULE DESCRIPTOR -Module Number- 0099111 -Session-1989-90 -Superclass- PB -Title- PRINCIPLES
More informationDifference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 4 Number 2 Difference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction
More informationRespiratory System Mechanics
M56_MARI0000_00_SE_EX07.qxd 8/22/11 3:02 PM Page 389 7 E X E R C I S E Respiratory System Mechanics Advance Preparation/Comments 1. Demonstrate the mechanics of the lungs during respiration if a bell jar
More informationUsing Spirometry to Rule Out Restriction in Patients with Concomitant Low Forced Vital Capacity and Obstructive Pattern
44 The Open Respiratory Medicine Journal, 2011, 5, 44-50 Using Spirometry to Rule Out Restriction in Patients with Concomitant Low Forced Vital Capacity and Obstructive Pattern Open Access Imran Khalid
More informationSpirometry: Introduction
Spirometry: Introduction Dr. Badri Paudel 1 2 GMC Spirometry Spirometry is a method of assessing lung function by measuring the volume of air the patient can expel from the lungs after a maximal expiration.
More informationUNIVERSITY OF JORDAN DEPT. OF PHYSIOLOGY & BIOCHEMISTRY RESPIRATORY PHYSIOLOGY MEDICAL STUDENTS FALL 2014/2015 (lecture 1)
UNIVERSITY OF JORDAN DEPT. OF PHYSIOLOGY & BIOCHEMISTRY RESPIRATORY PHYSIOLOGY MEDICAL STUDENTS FALL 2014/2015 (lecture 1) Textbook of medical physiology, by A.C. Guyton and John E, Hall, Twelfth Edition,
More informationبسم هللا الرحمن الرحيم
بسم هللا الرحمن الرحيم Yesterday we spoke of the increased airway resistance and its two examples: 1) emphysema, where we have destruction of the alveolar wall and thus reducing the area available for
More informationMSRC AIR Course Karla Stoermer Grossman, MSA, BSN, RN, AE-C
MSRC AIR Course Karla Stoermer Grossman, MSA, BSN, RN, AE-C Explain the importance of objective measures in the management of asthma Explain the different types of objective measures used in the management
More informationBiomedicalInstrumentation
University of Zagreb Faculty of Electrical Engineering and Computing BiomedicalInstrumentation Measurementofrespiration prof.dr.sc. Ratko Magjarević October 2013 Respiratorysystem Consistsofthelungs, airways
More informationCOMPREHENSIVE RESPIROMETRY
INTRODUCTION Respiratory System Structure Complex pathway for respiration 1. Specialized tissues for: a. Conduction b. Gas exchange 2. Position in respiratory pathway determines cell type Two parts Upper
More informationS P I R O M E T R Y. Objectives. Objectives 3/12/2018
S P I R O M E T R Y Dewey Hahlbohm, PA-C, AE-C Objectives To understand the uses and importance of spirometry testing To perform spirometry testing including reversibility testing To identify normal and
More informationThe objectives of the pre-anaesthetic assessment
Dr Gerard Meachery The objectives of the pre-anaesthetic assessment! Evaluate the patient s medical condition from medical history, physical examination, investigations and, when appropriate, past medical
More informationDLCO Webinar Q&A Dr. Christine Oropez answers post-presentation FAQs
DLCO Webinar Q&A Dr. Christine Oropez answers post-presentation FAQs If you re setting up bio controls, should they be measured at a specific window because of diurnal changes in DLCO? I would not necessarily
More information3 COPD Recognition and Diagnosis: Approach to the Patient with Respiratory Symptoms
William L. Eschenbacher, MD 3 COPD Recognition and Diagnosis: Approach to the Patient with Respiratory Symptoms Key Points 1. Patients who present with respiratory symptoms such as cough, sputum production,
More informationSubject Index. Carbon monoxide (CO) disease effects on levels 197, 198 measurement in exhaled air 197 sources in exhaled air 197
Subject Index Airway resistance airflow interruption measurement in preschoolers, see Forced oscillation technique; Interrupter technique plethysmography, see Plethysmography; Whole-body plethysmography
More informationClinical Study Bronchial Responsiveness in Patients with Restrictive Spirometry
BioMed Research International Volume 2013, Article ID 498205, 5 pages http://dx.doi.org/10.1155/2013/498205 Clinical Study Bronchial Responsiveness in Patients with Restrictive Spirometry Jean I. Keddissi,
More informationRespiratory Mechanics
Respiratory Mechanics Critical Care Medicine Specialty Board Tutorial Dr Arthur Chun-Wing LAU Associate Consultant Intensive Care Unit, Pamela Youde Nethersole Eastern Hospital, Hong Kong 17 th June 2014
More informationWORKSHOP OF LUNG FUNCTION TEST. Dr. Lo Iek Long, Department of Respiratory Medicine, CHCSJ, Macau
WORKSHOP OF LUNG FUNCTION TEST Dr. Lo Iek Long, Department of Respiratory Medicine, CHCSJ, Macau Big three in Respiratory Medicine Lung Function Test Chest imaging Bronchoscopy Table of Content Section
More informationTriennial Pulmonary Workshop 2012
Triennial Pulmonary Workshop 2012 Rod Richie, M.D., DBIM Medical Director Texas Life Insurance Company, Waco, TX EMSI, Waco, TX Lisa Papazian, M.D., DBIM Assistant Vice President and Medical Director Sun
More informationPFTs ACOI Board Review 2018
PFTs ACOI Board Review 2018 Thomas F. Morley, DO, MACOI, FCCP, FAASM Professor of Medicine Chairman Department of Internal Medicine Director of the Division of Pulmonary, Critical Care and Sleep Medicine
More informationMain findings. Comments
5 6 7 8 9 0 A recent study published in the European respiratory Journal, Dr. Yunus Çolack and his collaborators confirmed a link between the underdiagnosed airflow obstruction based on fixed FEV/FVC ratio
More informationEssen%als of Spirometry and Assessment
Essen%als of Spirometry and Assessment Objectives: 1. Review spirometric acceptability, reproducibility and reporting standards 2. Discuss lung volumes and capacities 3. Discuss Pre & Post bronchodilator
More information3. Which statement is false about anatomical dead space?
Respiratory MCQs 1. Which of these statements is correct? a. Regular bronchioles are the most distal part of the respiratory tract to contain glands. b. Larynx do contain significant amounts of smooth
More informationClinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene
Clinical and radiographic predictors of GOLD-Unclassified smokers in COPDGene Emily S. Wan, John E. Hokanson, James R. Murphy, Elizabeth A. Regan, Barry J. Make, David A. Lynch, James D. Crapo, Edwin K.
More informationRespiratory System. Chapter 9
Respiratory System Chapter 9 Air Intake Air in the atmosphere is mostly Nitrogen (78%) Only ~21% oxygen Carbon dioxide is less than 0.04% Air Intake Oxygen is required for Aerobic Cellular Respiration
More informationRespiratory Disease. Dr Amal Damrah consultant Neonatologist and Paediatrician
Respiratory Disease Dr Amal Damrah consultant Neonatologist and Paediatrician Signs and Symptoms of Respiratory Diseases Cardinal Symptoms Cough Sputum Hemoptysis Dyspnea Wheezes Chest pain Signs and Symptoms
More informationi. Zone 1 = dead space ii. Zone 2 = ventilation = perfusion (ideal situation) iii. Zone 3 = shunt
Respiratory Review I. Oxygen transport a. Oxygen content of blood i. Dissolved oxygen =.003 x PaO 2, per 100 ml plasma 1. Henry s Law ii. Oxygen on hemoglobin = 1.34 ml x sat x Hgb iii. CaO 2 = Dissolved
More informationbehaviour are out of scope of the present review.
explained about the test, a trial may be done before recording the results. The maneuver consists initially of normal tidal breathing. The subject then inhales to maximally fill the lungs. This is followed
More informationSPIROMETRY TECHNIQUE. Jim Reid New Zealand
Jim Reid New Zealand The Basics Jim Reid Spirometry measures airflow and lung volumes, and is the preferred lung function test in COPD. By measuring reversibility of obstruction, it is also diagnostic
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Primary Outcome/Efficacy Variable:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationSPIROMETRY METHOD. COR-MAN IN / EN Issue A, Rev INNOVISION ApS Skovvænget 2 DK-5620 Glamsbjerg Denmark
SPIROMETRY METHOD COR-MAN-0000-006-IN / EN Issue A, Rev. 2 2013-07 INNOVISION ApS Skovvænget 2 DK-5620 Glamsbjerg Denmark Tel.: +45 65 95 91 00 Fax: +45 65 95 78 00 info@innovision.dk www.innovision.dk
More informationI LUNG FUNCTION ASSESSMENT AND THORACIC DIAGNOSTIC TECHNIQUES
I LUNG FUNCTION ASSESSMENT AND THORACIC DIAGNOSTIC TECHNIQUES Roland H. Ingram, jr., m.d. Although the history and physical examination are essential to the diagnostic process, pulmonary signs and symptoms
More informationChronic Obstructive Pulmonary Disease
136 PHYSIOLOGY CASES AND PROBLEMS Case 24 Chronic Obstructive Pulmonary Disease Bernice Betweiler is a 73-year-old retired seamstress who has never been married. She worked in the alterations department
More informationSpirometry Workshop for Primary Care Nurse Practitioners
Spirometry Workshop for Primary Care Nurse Practitioners Catherine Casey S. Jones PhD, RN, AE-C, ANP-C Certified Adult Nurse Practitioner Texas Pulmonary & Critical Care Consultants P.A. and Adjunct Professor
More informationSpirometry: FEVER DISEASE DIABETES HOW RELIABLE IS THIS? 9/2/2010 BUT WHAT WE PRACTICE: Spirometers are objective tools
SPIROMETRY PRINCIPLES, PROCEDURE AND QA Spirometry: Dr. Rahul Kodgule CHEST RESEARCH FOUNDATION, PUNE FEVER ISCHAEMIC HEART DISEASE DIABETES BUT WHAT WE PRACTICE: Spirometers are objective tools to diagnose
More informationSpirometry and Flow Volume Measurements
Spirometry and Flow Volume Measurements Standards & Guidelines December 1998 To serve the public and guide the medical profession Revision Dates: December 1998 Approval Date: June 1998 Originating Committee:
More informationPathophysiology of COPD 건국대학교의학전문대학원
Pathophysiology of COPD 건국대학교의학전문대학원 내과학교실 유광하 Rate per 100 0,000 population 550 500 450 400 350 300 250 200 150 100 50 0 Heart disease Cancer Stroke 1970 1974 1978 1982 1986 1990 1994 1998 2002 Year of
More information#8 - Respiratory System
Page1 #8 - Objectives: Study the parts of the respiratory system Observe slides of the lung and trachea Equipment: Remember to bring photographic atlas. Figure 1. Structures of the respiratory system.
More informationInterpreting Spirometry. Vikki Knowles BSc(Hons) RGN Respiratory Nurse Consultant G & W`CCG
Interpreting Spirometry Vikki Knowles BSc(Hons) RGN Respiratory Nurse Consultant G & W`CCG Why Spirometry? supports diagnosis classifies defect - obstructive/restrictive assesses -severity of defect -
More informationReport Templates Available for EasyOne Pro (LAB) and Easy on-pc
Report Templates Available for EasyOne Pro (LAB) and Easy onpc Contents 1 Introduction... 1 2 Standard Report Templates... 2 2.1 FVC/FVL, Standard... 2 2.2 FVC, Large... 3 2.3 FVC/FVL, Large... 4 2.4 FVC/FVL,
More informationChronic Cough. Abhishek Kumar, MD, MPH Pulmonary and Critical Care Mercy Medical Center, Cedar Rapids, IA
Chronic Cough Abhishek Kumar, MD, MPH Pulmonary and Critical Care Mercy Medical Center, Cedar Rapids, IA What we shall discuss? Cough anatomy and pathophysiology Common etiologies Work-up Role of spirometry/pulmonary
More informationIn order to diagnose lung diseases doctors
You Take My Breath Away Activity 5C NOTE: This activity is designed to follow You Really Are Full of Hot Air! Activity Objectives: After completing You Really Are Full of Hot Air! Activity 5B, students
More informationSupplementary Online Content
Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published
More informationAuthor's response to reviews
Author's response to reviews Title: Vital capacity and inspiratory capacitiy as additional parameters to evaluate bronchodilator response in asthmatics patients: a cross section study Authors: Karen S
More informationMASTER SYLLABUS C. Course Number and Title: RESP 2410 Respiratory Care Equipment/Procedures IV
A. Academic Division: Health Sciences B. Discipline: Respiratory Care MASTER SYLLABUS 2018-2019 C. Course Number and Title: RESP 2410 Respiratory Care Equipment/Procedures IV D. Course Coordinator: Tricia
More informationCOPD. Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS
IN THE NAME OF GOD COPD Dr.O.Paknejad Pulmonologist Shariati Hospital TUMS Definition of COPD* COPD is a preventable and treatable chronic lung disease characterized by airflow limitation that is not fully
More informationDLCO versus DLCO/VA as predictors of pulmonary gas exchange $
Respiratory Medicine (2007) 101, 989 994 DLCO versus DLCO/VA as predictors of pulmonary gas exchange $ David A. Kaminsky a,, Todd Whitman b, Peter W. Callas c a Pulmonary Disease and Critical Care Medicine,
More informationWhat lung function data are relevant concerning the assessment of COPD patients for out patient rehabilitation?
What lung function data are relevant concerning the assessment of COPD patients for out patient rehabilitation? An information package on lung function tests and interpretation of test data in identifying
More informationOutline FEF Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications?
Reduced FEF25-75 in asthma. What does it mean and what are the clinical implications? Fernando Holguin MD MPH Director, Asthma Clinical & Research Program Center for lungs and Breathing University of Colorado
More informationInterpretative strategies for lung function tests
Eur Respir J 2005; 26: 948 968 DOI: 10.1183/09031936.05.00035205 CopyrightßERS Journals Ltd 2005 SERIES ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING Edited by V. Brusasco, R. Crapo and
More informationASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss?
ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? Randall W. Brown, MD MPH AE-C Association of Asthma Educators Annual Conference July 20, 2018 Phoenix, Arizona FACULTY/DISCLOSURES Randall Brown,
More informationUNIT TWO: OVERVIEW OF SPIROMETRY. A. Definition of Spirometry
UNIT TWO: OVERVIEW OF SPIROMETRY A. Definition of Spirometry Spirometry is a medical screening test that measures various aspects of breathing and lung function. It is performed by using a spirometer,
More information1. When a patient fails to ventilate or oxygenate adequately, the problem is caused by pathophysiological factors such as hyperventilation.
Chapter 1: Principles of Mechanical Ventilation TRUE/FALSE 1. When a patient fails to ventilate or oxygenate adequately, the problem is caused by pathophysiological factors such as hyperventilation. F
More information