Pulmonary Function Testing
- 1. Pulmonary Function Testing Janet Jobe CRTT CPFT RCP AE-C Carle Physician Group Pulmonary Function Lab & Education
- 2. Indications Diagnostic – signs & symptoms, ABN CXR, smokers, occupational exposures, pre- operative risk Monitoring – bronchodilator therapy, lung disease, CHF, pulmonary toxicity (Amiodarone, Chemotherapy, Rheumatologic)
- 3. Indications - continued Eval. of Disability/Impairment – SSI, progressive disease; ALS, Scleroderma, Cystic Fibrosis Public Health – epidemiologic surveys, research
- 4. Testing Basic testing Spirometry w/ or w/o MVV Pre & post bronchodilator spirometry Arterial blood gas (ABG) Pulse oximetry
- 5. Testing - continued Detailed testing Lung compartments (TLC) w/ or w/o airway resistance Diffusion capacity (DLCO) MIP/MEP
- 6. Testing - continued Special procedures Bronchoprovocational challenge Methacholine – contraindication; pregnancy/breast feeding Exercise (EIB) – consider physical or fitness limitation Metabolic stress testing to evaluate unexplained dyspnea through cardiac, pulmonary and physical fitness eval.
- 7. Testing - continued Studies to determine oxygen supplementation levels
- 8. Technical Requirements for Quality Testing Equipment – calibrations, Q.A. and maintenance Tester competency Patient effort ATS guidelines
- 9. Guidelines for Interpretation Normal function - > 80% Obstructive disease – affects expiration (i.e. asthma, A1AD, COPD) severity Restrictive disease – affects inspiration/expiration equally (i.e. pulmonary fibrosis, structural deformity) severity Con-commitant disease process
- 10. Treatment Bronchodilators (12% or > 200ml absolute improvement FEV1) Inhaled short acting bronchodilator Inhaled long lasting bronchodilator Inhaled anticholinergics Oral beta2 Leukotriene modifiers
- 11. Treatment - continued Corticosteriods/ anti-inflammatory Inhaled Oral Pulmonary or allergy consultation Recommendations Treat and follow (IGE therapy) Pulmonary rehabilitation program Patient education Smoking cessation
- 12. Questions?