Spirometry

Health care personnel can take a good benefit from these slides

1. spirometry By adnan qadir

2. Spirometry is the most common of the pulmonary function test (PTF’s) . It measures lung function specifically the amount (volume ) or speed of air that can be inhaled or exhaled . Spirometry ( pneumotachograhps )which generates charts that plot volume (amount) And flow (speed) of air coming in and out of the lungs from one inhalation and exhalation . INTRODUCTION

3. Spirometry is indicated for the following reasons : To diagnose asthama To detect respiratory disease in patients presenting with the symptoms of breathlessness. To diagnose and differentiate between obstructive and restrictive lung disease . To conduct pre operative risks assessment before anaesthesia or cardiothoracic surgery. To diagnose the vocal cords dysfunction . Indications

4. Spirometry should not be performed when the individual presented with : Hemoptysis of unkown origin Pneumothorax Unstable cardiovascular status (angina or recent MI) Thoracic , abdominal or cerebral aneurysms Cataracts or recent eye surgery Nausea or vomitting Active TB contraindications

5. The spirometry is performed by using a device called SPIROMETER , which comes in different varieties. Most spirometers display the followings graphs called SPIROGRAMS . A “VOLUME –TIME GRAPH” showing volume ( lts ) along y –axis and time (sec) along x – axis. A “FLOW –VOLUME LOOP” which graphically depicts the rate of airflow on y –axis and total volume inspired or expired on the x -axis Spirometer

6. Before starting test , keep following things in mind; Avoid alcohol before 4 hours Stop talking large meals before 2 hours Smoking should be stopped 1 hour before performing test Avoid vigorous exercise before 30 minutes Wear loose and comfortable clothes Patient should be relexed On advice of doctor certain medications may be avoided e.g inhalers Patient preparation

7. A spirometery test usually takes about 15 min , Here’s what happens during a spiromertry procedure : A patient is seated on a chair in an examination room. A doctor or nurse places a clip on nose to keep both nostrils closed. A cup like breathing mask is also placed around the mouth. Spirometry procedure

8. The doctor or nurse instructs patient to take a deep breathe in hold the breath for a few seconds and then exhale as hard as you can into the breathing mask. The test can be repeated at least three times to make sure that the results are constant.

9. If lot of variations between the results occur between the test than the highest value among the three is considered as final result. If there is any evidence of breathing disorder ,the doctor might give an inhaled medication known as bronchodialators to open up the lungs after the first round of test . The is then asked to wait for 15 min after then another set of measurement is done.

10. After doing another test the doctor than compare the results of these two measurements to known whether the bronchodialators have helped to increase the air flow or not.

11. Some of the few complaints the patient experience after the test are : Dizziness Shortness of breath immediately after the test . The test requires some exertion so it is not recommended if having HEART disease. Side effects

12. Spirometry measures two key factors EXPIRATORY FORCED VITAL CAPACITY (FVC) and FORCED EXPIRATORY VOLUME (FEV1). The doctor also looks at these as a combined no known as FEV1/FVC ratio. Normal values

13. One of the primary spirometery measurements is FVC, which is the greatest total amount of air one can forcefully breathe out after breathing in as deeply as possible. If FVC is lower than normal, something is restricting the breathing. Normal and abnormal results are evaluated differently between the adults and children fvc

14. For children aged 5 – 18 years Percentage of predicted Result FVC value 80% or greater Normal Less than 80% Abnormal

15. For Adults FVC Results Is greater than or equal to Normal The lower limit of normal Is less than the lower limit Abnormal of normal

16. An abnormal FVC could be due to restrictive or obstructive lung disease. An obstructive or restrictive lung disease could be present by itself , but its possible to have a mixture of these two types at same time.

17. The second key spirometry measurement is forced expiratory volume (FEV1). This is amount of air one can force out of lungs in one second . It helps the physician to know the severity of breathing problems A lower than normal FEV1 reading shows one might have a significant breathing obstruction. FEV1

18. Normal and abnormal values according to guidelines from the American Thoracic Society. Percentage of predicted Results FEV1 80% or greater Normal 70-79% Mildly abnormal 60-69% Moderately abnormal 50-59% Moderate-severely abnormal 35-49% Severely abnormal Less than 35% Very severely abnormal

19. The FEV1/FVC ratio is a no that represents the %age of lung capacity one is able to exhale in one second Higher %age represents normal or healthier lungs while low ratio suggests something is blocking airway Fev1/ fvc ratio

20. SMOKING IS HATE TO NOSE ,HARMFUL TO BRAIN AND DANGEROUS TO THE LUNGS DO U TAKE OR ...............