Spirometry and Pulmonary Function Testing

[Helge V. Keitel]

We're going to start a separate Ning for medicine, health and wellness within a few days but I decided to start a discussion about spirometry and lung function testing here as well.

Alternative Names PFTs; Spirometry; Spirogram; Lung function tests

Pulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move oxygen into the blood.

How the Test is Performed In a spirometry test, you breathe into a mouthpiece that is connected to an instrument called a spirometer. The spirometer records the amount and the rate of air that you breathe in and out over a period of time.

For some of the test measurements, you can breathe normally and quietly. Other tests require forced inhalation or exhalation after a deep breath.

Lung volume measurement can be done in two ways:

* The most accurate way is to sit in a sealed, clear box that looks like a telephone booth (body plethysmograph) while breathing in and out into a mouthpiece. Changes in pressure inside the box help determine the lung volume.

* Lung volume can also be measured when you breathe nitrogen or helium gas through a tube for a certain period of time. The concentration of the gas in a chamber attached to the tube is measured to estimate the lung volume.

To measure diffusion capacity, you breathe a harmless gas for a very short time, often one breath. The concentration of the gas in the air you breathe out then is measured. The difference in the amount of gas inhaled and exhaled can help estimate how quickly gas can travel from the lungs into the blood.

COPD explained. Early Trial Results Show Promise In COPD, Fifth Leading Cause of Death Worldwide. Improved quality of life measurements among people suffering from the serious and potentially fatal respiratory disorder known as chronic obstructive pulmonary disease (COPD).

[Helge V. Keitel]

The Diagnosis Problem in Pulmonary Tuberculosis METHODS for diagnosing pulmonary tuberculosis have been so standardized in the ... that the general practitioner should readily detect an early lesion.

The source of this information is from "Copyright © 1935 American College of Chest Physicians
Downloaded from www.chestjournal.org on January 17, 2009."

I wanted to get a quick look at possible Ning-platforms for pulmonary function testing and spirometry but haven't found a source yet. But there are numerous medical forums. The question is, what way to go?

- Start a Ning to discuss medical applications
- Or should we go directly to forums and groups discussing a specific health issue?

Certain criteria have been set up and emphasized, such as fatigue over a period of time, a history of one or more attacks of pleurisy particularly if accompanied by effusion, cough, loss of weight and hemorrhage.

A preponderance of any of these symptoms should at least indicate a strong probability of tuberculosis. If added to a majority of these symptoms we have fever, particularly afternoon rise, plus night sweats the diagnosis becomes more sure. To clinch it we take an x-ray picture for corroboration.

Finally we examine the sputum which, if containing tubercle bacilli, makes the diagnosis certain.

[Helge V. Keitel]

A joint document sponsored by two international pulmonary medicine organiza..., both the American Thoracic Society (ATS) and the European Respiratory Society (ERS), as well as the Global Initiative for Chronic Obstructive Lung Disease guidelines indicate that spirometry is necessary for the diagnosis of COPD.

The ATS/ERS standards1 advocate performing spirometry in all persons with a history of exposure to cigarette smoke and/or environmental pollutants, a family history of COPD, or the presence of a chronic cough, sputum production, or shortness of breath.

Additionally, the National Committee for Quality Assurance has recently adopted spirometry as a performance measure for the Health Plan Employer Data and Information Set in patients with a new diagnosis of COPD.

The story continues on the page. I just wanted to make a note about the organizations.

Abstract

COPD continues to cause a heavy health and economic burden both in the United States and around the world. Some of the risk factors for COPD are well-known and include

- smoking,
- occupational exposures,
- air pollution,
- airway hyperresponsiveness,
- asthma, and
- certain genetic variations,

although many questions, such as why < 20% of smokers develop significant airway obstruction, remain.

Precise definitions of COPD vary and are frequently dependent on an accurate diagnosis of the problem by a physician.

These differences in the definition of COPD can have large effects on the estimates of COPD in the population. Furthermore, evidence that COPD represents several different disease processes with potentially different interventions continues to emerge.

In most of the world, COPD prevalence and mortality are still increasing and likely will continue to rise in response to increases in smoking, particularly by women and adolescents. Resources aimed at smoking cessation and prevention, COPD education and early detection, and better treatment will be of the most benefit in our continuing efforts against this important cause of morbidity and mortality.

[Helge V. Keitel]

[Helge V. Keitel]

[Helge V. Keitel]

[Helge V. Keitel]

The web is a learning environment.

Respiratory Volumes and Pulmonary Function Tests

View SlideShare presentation or Upload your own. (tags: resvol.refunc)

[Helge V. Keitel]

I continue to write notes about pulmonary testing, how patients are inhaling and exhaling during the test.

A few minutes ago, I came across a blog where the person writes, "Yesterday I passed the dreaded pulmonary function testing, which is required for insurance purposes. I did it before my other transplants, but I was worried that the still-resolving pneumonia might make it more difficult. I guess the purpose of the test is to show that your lungs can hold up under transplant, but it’s as much a mental as a physical exercise, which you could fail just by having a panic attack."

A technician puts a clip over your nose and leads you through various tests.

1. For one test, you put your mouth around a tube and breathe in and out and then take a deep breath in and push push push all the air out until you think you might turn blue.

2. For another test, you put your mouth around a piece of equipment that looks like a snorkel and then, with nose clip on, breathe evenly for about two minutes and then do a big inhale and exhale.

"There was some writing on the bottom of the machine and I repeated each letter to myself to distract myself from the sensation that I was drowning," she writes.