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 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 full-service 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 function testing and respiratory management training are available at our satellite locations, as well. Pulmonary function tests 1. Forced vital capacity (FVC) Performed w/ maximally forced expiratory effort Remarks: Often reduced in COPD because of air trapping 2. Forced expiratory volume (FEV) Volume of air exhaled in a specified time during the performance of forced vital capacity; FEV is volume exhaled in 1 sec. Remarks: Valuable clue to the severity of the expiratory airway obstruction

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Ratio of timed force expiratory volume to forced vital capacity (FEVt/FVC% usually FEV1 /FVC% ) FEV expressed as percentage for the forced vital capacity remarks: Another way of expressing the presence or absence of airway obstruction Forced expiratory flow (FEF 200-1200 ) Forced expiratory flow bet. 200 & 1200 mL of FVC remarks: Indicator of large airway obstruction Forced midexpiratory flow (FEF 25-75% ) Forced expiratory flow during middle half of FVC remarks: Slowed in small airway obstruction Forced end expiratory flow (FEF 75-85% ) Forced expiratory flow during the terminal portion of the FVC remarks: Slowed in obstruction of smaller airways Maximal voluntary ventilation (MVV ) Vol. Of air expired in specific period (12 sec) during repetitive maximal effort remarks: Important factor in exercise tolerance

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