Pulmonary function testing: Difference between revisions

Revision as of 11:51, 22 April 2021

Revision as of 17:35, 15 June 2022

Line 18:

}}

{{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>Pulmonary terms and symbols: a report of the ACCP-ATS Joint Committee on Pulmonary Nomenclature, Chest 67:583, 1975</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 technician, respiratory therapist, respiratory physiologist, physiotherapist, [[pulmonology|pulmonologist]], and/or general practitioner.

==Indications==

Line 39:

Spirometry includes tests of pulmonary mechanics – measurements of FVC, FEV₁, FEF values, forced inspiratory flow rates (FIFs), and MVV. Measuring pulmonary mechanics assesses the ability of the lungs to move huge volumes of air quickly through the airways to identify airway obstruction.

The measurements taken by the spirometry device are used to generate a [[pneumotachograph]] that can help to assess lung conditions such as: asthma, pulmonary fibrosis, cystic fibrosis, and chronic obstructive pulmonary disease. [[Physician]]s may also use the test results to diagnose bronchial hyperresponsiveness to exercise, cold air, or pharmaceutical agents.<ref>Pulmonary Function Test in New York, Article. June 2010. Dr. Marina Gafanovich, MD - 1550 York Ave, New York NY 10028 - [phone]. [http://www.mynycdoctor.com/pulmonary-function-testing NYC Pulmonary Function Test.]</ref>

====Complications of spirometry====

Line 47:

===Lung volumes===

{{Main|Lung volumes}}

There are four lung volumes and four lung capacities. A lung's capacity consists of two or more lung volumes. The lung volumes are [[tidal volume]] (V_T), [[inspiratory reserve volume]] (IRV), [[expiratory reserve volume]] (ERV), and [[Lung volumes|residual volume]] (RV). The four lung capacities are [[total lung capacity]] (TLC), [[inspiratory capacity]] (IC), [[functional residual capacity]] (FRC) and [[vital capacity]] (VC).

===Maximal respiratory pressures===

Line 58:

===Oxygen desaturation during exercise===

The [[six-minute walk test]] is a good index of physical function and therapeutic response in patients with [[chronic lung disease (disambiguation)|chronic lung disease]], such as [[COPD]] or [[idiopathic pulmonary fibrosis]].<ref name="pmid12890299">{{cite journal| author=Enright PL| title=The six-minute walk test. | journal=Respir Care | year= 2003 | volume= 48 | issue= 8 | pages= 783–5 | pmid=12890299 }}</ref><ref name="pmid19996335">{{cite journal |vauthors=Swigris JJ, Wamboldt FS, Behr J, du Bois RM, King TE, Raghu G, etal | title=The 6 minute walk in idiopathic pulmonary fibrosis: longitudinal changes and minimum important difference. | journal=Thorax | year= 2010 | volume= 65 | issue= 2 | pages= 173–7 | pmid=19996335 | doi=10.1136/thx.2009.113498 | pmc=3144486}}</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=Am J Respir Crit Care Med | year= 2002 | volume= 166 | issue= 1 | pages= 111–7 | pmid=12091180 | doi= 10.1164/ajrccm.166.1.at1102}}</ref>

===Arterial blood gases===

Line 81:

==Interpretation of tests==

{{See also|Spirometer#History - Interpreting Spirometry}}

Professional societies such as the [[American Thoracic Society]] and the [[European Respiratory Society]] have published guidelines regarding the conduct and interpretation of pulmonary function testing to ensure standardization and uniformity in performance of tests. The interpretation of tests depends on comparing the patients values to published normals from previous studies. Deviation from guidelines can result in false-positive or false negative test results., Mohankaeven MR et al. recently demonstrated thatthough only a small minority of pulmonary function laboratories followed published guidelines for spirometry, lung volumes and diffusing capacity in 2012.<ref>{{cite journal|last1=Mohanka|first1=Manish R.|last2=McCarthy|first2=Kevin|last3=Xu|first3=Meng|last4=Stoller|first4=James K.|title=A Survey of Practices of Pulmonary Function Interpretation in Laboratories in Northeast Ohio|journal=Chest|date=April 2012|volume=141|issue=4|pages=1040–1046|doi=10.1378/chest.11-1141|pmid=21940775}}</ref>

==Significance Risks ==

Pulmonary function testing is a safe procedure; however, there is cause for concern regarding untoward reactions and the value of the test data should be weighed against potential hazards. Some complications have been reported, including [[pneumothorax]], increased intracranial pressure, [[syncope (medicine)|fainting]], chest pain, paroxysmal coughing, [[nosocomial infection]]s, oxygen desaturation, and [[bronchospasm]].

Changes in lung volumes and capacities are generally consistent with the pattern of impairment. TLC, FRC, and RV increase with [[obstructive lung disease]]s and decrease with [[restrictive lung disease]]s.

==Clinical significance==

Changes in lung volumes and capacities are generally consistent with the pattern of impairment. TLC, FRC, and RV increase with [[obstructive lung disease]]s and decrease with [[restrictive lung disease]]s.

==References==