Notes
Notes
PFT
Notes
Pulmonary Function Testing Pocket Guide
F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
As new scientific information becomes available through basic and clinical research,
recommended treatments and drug therapies undergo changes. The author(s) and
publisher have done everything possible to make this book accurate, up to date, and
in accord with accepted standards at the time of publication. The author(s), editors,
and publisher are not responsible for errors or omissions or for consequences from
application of the book, and make no warranty, expressed or implied, in regard to
the contents of the book. Any practice described in this book should be applied by
the reader in accordance with professional standards of care used in regard to the
unique circumstances that may apply in each situation. The reader is advised always
to check product information (package inserts) for changes and new information
regarding dose and contraindications before administering any drug. Caution is
especially urged when using new or infrequently ordered drugs.
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HIPAA Compliant
OSHA Compliant
15
Indications for Spirometry
AARC Clinical Practice
ATS: Standardization of Guidelines: Spirometry 1996
Spirometry, 2005 Revision and Update
Diagnostic
Evaluate symptoms, signs, or Detect absence or presence of
abnormal laboratory tests. lung dysfunction suggested
Measure the effect of disease by history or physical signs
on pulmonary function. and symptoms and/or the
Assess risk for pulmonary presence of other abnormal
disease. diagnostic tests (e.g., chest
Assess preoperative risk. radiograph, analysis of arterial
Assess prognosis. blood gases).
Assess heath status before Quantify the severity of known
beginning strenuous physical lung disease.
activity programs.
Assess therapeutic Assess the change in lung
intervention. function over time or follow-
Describe the course of ing administration of or
diseases that affect lung change in therapy.
function. Assess the potential effects or
Monitor people exposed to response to environmental or
injurious agents. occupational exposure.
Monitor for adverse reactions
to drugs with known pul-
monary toxicity.
Disability/Impairment Evaluations
Assess patients as a part of a Assess the risk for surgical
rehabilitation program. procedures known to affect
Assess risks as part of an lung function.
insurance evaluation.
Assess individuals for legal
reasons.
Continued
SPIROM-
ETRY
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29
Significance
Decreased PEF
Poor effort
Obstructive diseases
Portable Peak Flow Monitoring
Portable peak flow meters may be used by patients in the home
setting to monitor asthma symptoms. The equipment and tech-
nique is easily taught and self-performed by the patient. A Zone
system is recommended to assist the patient in monitoring his/her
symptoms.
SPIROM-
ETRY
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57
Changes With Disease
Obstructive Disease Pattern
N2
80
60
40
20
0
0 2 4 6 8
Volume (L)
60
40
20
0
0 2 4 6 8
Volume (L)
LUNG
VOLS
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LUNG
VOLS
Helium Dilution
Perform volume/flow calibration
No Calibration
3.5% or 65 mL?
Yes
60
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DIFFUS
DISTR
2
Jones
1 0.3 t l
RV
0
0 2 4 6 8 10 1 1
Time (s)
82
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93
Total Lung Capacity (TLC) Determination
Total lung capacity (TLC) may be determined by integrating the
area under the exhaled N2 curve. This may be done by planimetry
or by the computer-based system integrating the area electroni-
cally. Residual volume (RV) is then determined by subtracting the
vital capacity (VC) from the TLC.
Acceptability Criteria
Mean expiratory flow rate must be <0.5 L/second.
After 500 mL, expiratory flows must not exceed 0.7 L/second
for more than 300 mL.
Inspiratory and expiratory VCs must be plus or minus 5% or
200 mL.
Cardiac oscillations must be minimal; to minimize cardiac
oscillations, increase expiratory flows (but not greater than
0.5 L/second).
Reproducibility Criteria
Tests meet acceptability criteria.
Expiratory VCs are 5% or 200 mL.
CV and CC 10%.
DIFFUS
DISTR