Assessment of Respiratory Function

Pulmonary Function Test

Definition
Routinely used in patients w/ chronic respiratory disorders. Example: Tuberculosis, Asthma, Cystic Fibrosis, Chronic Lung Disease (Bronchopulmonary Dysplasia), Lung Transplants - The tests can determine the cause of shortness of breath and may help confirm lung diseases, such as asthma, bronchitis or emphysema. The tests also are performed before any major lung surgery to make sure the person won't be disabled by having a reduced lung capacity.

Purpose

Useful in monitoring the course of a patient w/ an established respiratory disease & assessing the response to therapy. Useful in screening test in potentially hazardous places. Prior to surgery, used to screen patients scheduled for thoracic & upper abdominal surgical procedures. Obese & symptomatic patients Evaluation of respiratory symptoms & disability

Spirometer

Term used

Symbol

Description
Performed w/ maximally forced expiratory effort Volume of air exhaled in a specified time during the performance of forced vital capacity; FEV is volume exhaled in 1 sec. FEV expressed as percentage for the forced vital capacity Forced expiratory flow bet. 200 & 1200 mL of FVC

Remarks
Often reduced in COPD because of air trapping

Forced vital capacity FVC

Forced expiratory volume

FEV(FEV1 )

Valuable clue to the severity of the expiratory airway obstruction

Another way of expressing the presence or absence of airway obstruction Indicator of large airway obstruction

Ratio of timed force expiratory volume to forced vital capacity Forced expiratory flow

FEVt/FVC% usually FEV1 /FVC%

FEF 200-1200

Forced midexpiratory flow

Forced end expiratory flow Maximal voluntary

FEF 25-75%

Forced expiratory flow during middle half of FVC

Forced expiratory flow during the terminal portion of the FVC Vol. Of air expired in

Slowed in small airway obstruction

Slowed in obstruction of smaller airways Important factor in

FEF 75-85%

MVV

Normal Values Normal values are based upon the age, height, ethnicity, and sex of the person being tested. Normal results are expressed as a percentage. A value is usually considered abnormal if it is less than 80% of the predicted value for that person. What abnormal results mean? Abnormal results usually mean that a degree of chest or lung disease may be present. Special considerations Cooperation from the patient performing the test is crucial in providing accurate results. A poor seal around the mouthpiece of the spirometer can give poor results that do not permit interpretation. Do not smoke before the test. The Pulmonary, Critical Care and Sleep Medicine Division operates a fullservice state-of-the-art pulmonary function laboratory. There are 3 stations, including 2 body boxes and a station for cardiopulmonary exercise testing. Arterial blood gas sampling and exercise oximetry testing for home oxygen evaluations are also available. PFTs are performed on both inpatients and outpatients for diagnosis and management of respiratory conditions, preoperative assessments, disability evaluations. Cardiopulmonary exercise testing is performed to evaluate patients with unexplained dyspnea, to follow the course of a respiratory disorder and the response to treatment and for evaluation prior to enrollment in our Pulmonary Rehabilitation Program. Respiratory management training is also available, including: meter-dosed inhaler technique, the proper use of spacers, peak flow monitoring, and airway clearance modalities (such as PEP therapy, flutter valve and postural drainage). In addition to our full-service laboratory on the main campus, limited pulmonary

Reported by: Roderick G. Agbuya