Pulmonary function testing: Difference between revisions

Revision as of 15:31, 29 May 2024

Latest revision as of 14:21, 18 July 2025

(6 intermediate revisions by 3 users not shown)

Line 20:

}}

{{Pulmonary function}}

'''Pulmonary function testing''' ('''PFT''') is a complete evaluation of the [[respiratory system]] including patient history, physical examinations, and tests of pulmonary function. The primary purpose of pulmonary function testing is to identify the severity of pulmonary impairment.<ref>{{cite journal | vauthors = Burrows B | title = Pulmonary terms and symbols: A report of the ACCP-ATS joint committee on pulmonary nomenclature. | journal = Chest | date = May 1975 | volume = 67 | issue = 5 | pages = 583–593 | doi = 10.1378/chest.67.5.583 | pmid = 1126197 }}</ref> Pulmonary function testing has diagnostic and therapeutic roles and helps clinicians answer some general questions about patients with lung disease. PFTs are normally performed by a pulmonary function techniciantechnologist, respiratory therapist, respiratory physiologist, physiotherapist, [[pulmonology|pulmonologist]], or general practitioner.

==Indications==

Line 48:

==== Helium dilution ====

{{Main|Helium dilution technique}}

The [[helium dilution technique]] for measuring lung volumes uses a closed, rebreathing circuit.<ref name="pmid5475674">{{cite journal | vauthors = Hathirat S, Mitchell M, Renzetti AD | title = Measurement of the total lung capacity by helium dilution in a constant volume system | journal = The American Review of Respiratory Disease | volume = 102 | issue = 5 | pages = 760–70 | date = November 1970 | pmid = 5475674 | doi = 10.1164/arrd.1970.102.5.760 | doi-broken-date = 3112 JanuaryJuly 20242025 }}</ref> This technique is based on the assumptions that a known volume and concentration of helium in air begin in the closed [[spirometer]], that the patient has no helium in their lungs, and that an equilibration of helium can occur between the spirometer and the lungs.{{cn|date=November 2023}}

==== Nitrogen washout ====

Line 73:

===Oxygen desaturation during exercise===

The six-minute walk test is a good index of physical function and therapeutic response in patients with [[chronica lung disease (disambiguation)|chronic [[lung disease]], such as [[COPD]] or [[idiopathic pulmonary fibrosis]].<ref name="pmid12890299">{{cite journal | vauthors = Enright PL | title = The six-minute walk test | journal = Respiratory Care | volume = 48 | issue = 8 | pages = 783–785 | date = August 2003 | pmid = 12890299 }}</ref><ref name="pmid19996335">{{cite journal | vauthors = Swigris JJ, Wamboldt FS, Behr J, du Bois RM, King TE, Raghu G, Brown KK | title = The 6 minute walk in idiopathic pulmonary fibrosis: longitudinal changes and minimum important difference | journal = Thorax | volume = 65 | issue = 2 | pages = 173–177 | date = February 2010 | pmid = 19996335 | pmc = 3144486 | doi = 10.1136/thx.2009.113498 }}</ref><ref name="pmid12091180">{{cite journal | author = ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories | title = ATS statement: guidelines for the six-minute walk test | journal = American Journal of Respiratory and Critical Care Medicine | volume = 166 | issue = 1 | pages = 111–117 | date = July 2002 | pmid = 12091180 | doi = 10.1164/ajrccm.166.1.at1102 }}</ref>

===Arterial blood gases===

Line 93:

In order for the forced vital capacity to be considered accurate it has to be conducted three times where the peak is sharp in the flow-volume curve and the exhalation time is longer than 6 seconds.

ReproducibilityRepeatability of the PFT is determined by comparing the values of forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1). The difference between the highest values of two FVCs need to be within 5% or 150 mL. When the FVC is less than 1.0 L, the difference between the highest two values must be within 100 mL. Lastly, the difference between the two highest values of FEV1 should also be within 150 mL. The highest FVC and FEV1 may be used from each different test. Until the results of three tests meet the criteria of reproducibility, the test can be repeated up to eight times. If it is still not possible to get accurate results, the best three tests are used.<ref>{{cite journal | vauthors = Sim YS, Lee JH, Lee WY, Suh DI, Oh YM, Yoon JS, Lee JH, Cho JH, Kwon CS, Chang JH | display-authors = 6 | title = Spirometry and Bronchodilator Test | journal = Tuberculosis and Respiratory Diseases | volume = 80 | issue = 2 | pages = 105–112 | date = April 2017 | pmid = 28416951 | pmc = 5392482 | doi = 10.4046/trd.2017.80.2.105 }}</ref>

==Clinical significance==

Line 162:

* <math>MIP_{LLN}</math> = maximum inspiratory pressure lower limit of normal in cmH20

* <math>MEP_{LLN}</math> = maximum expiratory pressure lower limit of normal in cmH20

* <math>age</math> = the patient's age in years<ref>{{cite journal |vauthors=Evans JA, Whitelaw WA |date=October 2009 |title=The assessment of maximal respiratory mouth pressures in adults |url=https://pubmed.ncbi.nlm.nih.gov/19796415/ |journal=Respiratory Care |volume=54 |issue=10 |pages=1348–1359 |pmid=19796415}}</ref>

== References ==