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SPIROMETRY -
INTRODUCTION
Spirometry is a simple test used to help diagnose and
monitor certain lung conditions by measuring how much air
someone can breathe out in one forced breathe.it is
carried out by a device known as spirometer.
WHAT IS SPIROMETRY?
Spirometry is a method of
assessing lung function by
measuring the total volume of air
the patient can expel from the
lungs after a maximal inhalation.
SPIROMETRY – USES
• Measure airflow obstruction to help make a definitive
diagnosis of COPD
• Confirm presence of airway obstruction
• Assess severity of airflow obstruction in COPD
• Detect airflow obstruction in smokers who may have few or no
symptoms
• Monitor disease progression in COPD
• Assess one aspect of response to therapy
• Assess prognosis (FEV1) in COPD
• Perform pre-operative assessment
TYPES OF SPIROMETERS
• Bellows spirometers:
Measure volume; mainly in lung function units
• Electronic desk top spirometers:
Measure flow and volume with real time display
• Small hand-held spirometers:
Inexpensive and quick to use but no print out
3 Ball Spirometer
STANDARD SPIROMETRIC INDICATIONS
• FEV1 - Forced expiratory volume in one second:
The volume of air expired in the first second of the blow
• FVC - Forced vital capacity:
The total volume of air that can be forcibly exhaled in one
breath
• FEV1/FVC ratio:
The fraction of air exhaled in the first second relative to
the total volume exhaled
ADDITIONAL SPIROMETRIC INDICATIONS
• VC - Vital capacity:
A volume of a full breath exhaled in the patient’s own time
and not forced. Often slightly greater than the FVC,
particularly in COPD
• FEV6 – Forced expired volume in six seconds:
Often approximates the FVC. Easier to perform in older
and COPD patients but role in COPD diagnosis remains
under investigation
• MEFR – Mid-expiratory flow rates:
Derived from the mid portion of the flow volume curve but is
not useful for COPD diagnosis
LUNG VOLUME TERMINOLOGY
CRITERIA FOR NORMAL
POST-BRONCHODILATOR SPIROMETRY
•FEV1: > 80%
•FVC: > 80%
•FEV1/FVC: > 0.7 - 0.8, depending on age
NORMAL TRACE SHOWING FEV1
AND FVC
1 2 3 4 5 6
1
2
3
4
Volume,
liters
Time, sec
FVC
5
1
FEV1 = 4L
FVC = 5L
FEV1/FVC = 0.8
DISEASES ASSOCIATED WITH
AIRFLOW OBSTRUCTION
•COPD
•Asthma
•Bronchiectasis
•Cystic Fibrosis
•Post-tuberculosis
•Lung cancer (greater risk in COPD)
Obstructive
Restrictive
Time Time
Volume
Volume
SPIROMETRY: ABNORMAL PATTERNS
• FEV1 has dropped
significantly
• FVC decreases
slightly.
• FEV1/FVC ratio
decreased.
• RV increased
• FEV1 dropped
slightly.
• FVC decreases
massively.
• RV decreases
• FEV1/FVC ratio
remains same
FEV1
FVC
FEV1 (not as
much as
obstructive)
FVC<
PERFORMING SPIROMETRY -
PREPARATION
1.
Explain the purpose of the test and
demonstrate the procedure
2.
Record the patient’s age, height and
gender .
3.
Note when bronchodilator was last
used
4.
Have the patient sitting comfortably
5.
Loosen any tight clothing
PERFORMING SPIROMETRY
• Breath in until the lungs are full
• Hold the breath and seal the lips
tightly around a clean mouthpiece
• Blast the air out as forcibly and
fast as possible. Provide lots of
encouragement!
• Continue blowing until the lungs
feel empty
•Watch the patient during the blow
to assure the lips are sealed
around the mouthpiece
•Check to determine the breathe
holding time is normal or not.
(normal=25sec)
•Repeat the procedure at least twice
more until ideally 3 readings .
Performing Spirometry
THANK YOU
I HOPE FOR THE BEST
- BY ARKA DAS(CCT-06)

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SPIROMETRY @arka presentation by Arka Das.ppt

  • 1. SPIROMETRY - INTRODUCTION Spirometry is a simple test used to help diagnose and monitor certain lung conditions by measuring how much air someone can breathe out in one forced breathe.it is carried out by a device known as spirometer.
  • 2. WHAT IS SPIROMETRY? Spirometry is a method of assessing lung function by measuring the total volume of air the patient can expel from the lungs after a maximal inhalation.
  • 3. SPIROMETRY – USES • Measure airflow obstruction to help make a definitive diagnosis of COPD • Confirm presence of airway obstruction • Assess severity of airflow obstruction in COPD • Detect airflow obstruction in smokers who may have few or no symptoms • Monitor disease progression in COPD • Assess one aspect of response to therapy • Assess prognosis (FEV1) in COPD • Perform pre-operative assessment
  • 4. TYPES OF SPIROMETERS • Bellows spirometers: Measure volume; mainly in lung function units • Electronic desk top spirometers: Measure flow and volume with real time display • Small hand-held spirometers: Inexpensive and quick to use but no print out
  • 6. STANDARD SPIROMETRIC INDICATIONS • FEV1 - Forced expiratory volume in one second: The volume of air expired in the first second of the blow • FVC - Forced vital capacity: The total volume of air that can be forcibly exhaled in one breath • FEV1/FVC ratio: The fraction of air exhaled in the first second relative to the total volume exhaled
  • 7. ADDITIONAL SPIROMETRIC INDICATIONS • VC - Vital capacity: A volume of a full breath exhaled in the patient’s own time and not forced. Often slightly greater than the FVC, particularly in COPD • FEV6 – Forced expired volume in six seconds: Often approximates the FVC. Easier to perform in older and COPD patients but role in COPD diagnosis remains under investigation • MEFR – Mid-expiratory flow rates: Derived from the mid portion of the flow volume curve but is not useful for COPD diagnosis
  • 9. CRITERIA FOR NORMAL POST-BRONCHODILATOR SPIROMETRY •FEV1: > 80% •FVC: > 80% •FEV1/FVC: > 0.7 - 0.8, depending on age
  • 10. NORMAL TRACE SHOWING FEV1 AND FVC 1 2 3 4 5 6 1 2 3 4 Volume, liters Time, sec FVC 5 1 FEV1 = 4L FVC = 5L FEV1/FVC = 0.8
  • 11. DISEASES ASSOCIATED WITH AIRFLOW OBSTRUCTION •COPD •Asthma •Bronchiectasis •Cystic Fibrosis •Post-tuberculosis •Lung cancer (greater risk in COPD)
  • 12. Obstructive Restrictive Time Time Volume Volume SPIROMETRY: ABNORMAL PATTERNS • FEV1 has dropped significantly • FVC decreases slightly. • FEV1/FVC ratio decreased. • RV increased • FEV1 dropped slightly. • FVC decreases massively. • RV decreases • FEV1/FVC ratio remains same FEV1 FVC FEV1 (not as much as obstructive) FVC<
  • 13. PERFORMING SPIROMETRY - PREPARATION 1. Explain the purpose of the test and demonstrate the procedure 2. Record the patient’s age, height and gender . 3. Note when bronchodilator was last used 4. Have the patient sitting comfortably 5. Loosen any tight clothing
  • 14. PERFORMING SPIROMETRY • Breath in until the lungs are full • Hold the breath and seal the lips tightly around a clean mouthpiece • Blast the air out as forcibly and fast as possible. Provide lots of encouragement! • Continue blowing until the lungs feel empty
  • 15. •Watch the patient during the blow to assure the lips are sealed around the mouthpiece •Check to determine the breathe holding time is normal or not. (normal=25sec) •Repeat the procedure at least twice more until ideally 3 readings . Performing Spirometry
  • 16. THANK YOU I HOPE FOR THE BEST - BY ARKA DAS(CCT-06)