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Spirometry and peak flow metry in bronchial asthma
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Spirometry and peak flow metry in bronchial asthma

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SPIROMETRY AND PEAK FLOMETRY in BRONCHIAL ASTHMA …

SPIROMETRY AND PEAK FLOMETRY in BRONCHIAL ASTHMA
SPIROMETRY IS A PULMONARY FUNCTION TEST THAT MEASURES THE VOLUME OF AIR AN INDIVIDUAL INHALES OR EXHALES AS A FUNCTION OF TIME.

SPIROMETRY MEASURES HOW MUCH AND HOW QUICKLY AIR CAN BE EXPELLED FOLLOWING A DEEP BREATH.

FLOW , OR THE RATE AT WHICH VOLUME IS CHANGING AS A FUNCTION OF TIME, CAN ALSO BE MEASURED WITH SPIROMETRY.


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  • 1. WORLD ASTHMA DAY 2012 YOU CAN CONTROL YOUR ASTHMAworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 2. SPIROMETRY AND PEAK FLOMETRYINBRONCHIAL ASTHMAPresented byDr. PANKAJYADAVdrpankajyadav05@gmail.comworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 3.  SPIROMETRY IS A PULMONARY FUNCTIONTESTTHATMEASURESTHE VOLUME OF AIR AN INDIVIDUALINHALES OR EXHALES AS A FUNCTION OF TIME. SPIROMETRY MEASURES HOW MUCH AND HOWQUICKLYAIR CAN BE EXPELLED FOLLOWING A DEEPBREATH. FLOW , ORTHE RATE ATWHICHVOLUME IS CHANGINGASA FUNCTION OFTIME, CAN ALSO BE MEASUREDWITH SPIROMETRY.world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRCWHAT IS SPIROMETRY ?
  • 4.  EARLIEST SPIROMETRIC MEASUREMENT OF LUNGVOLUMES AND ITS EXPIRABLE COMPONENTS WASDONE BY HUTCHINSON IN 1846 EQUIPMENT FORTESTING CHILDREN SHOULD BECAPABLE OF MEASURING SMALLVOLUMES AND LOWFLOWS CAN BE PERFORMED BYTHE AGE OF 3YEARSworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 5. SPIROMETERworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 6. Method – how to perform1. 4 normal breaths2. Inhale as deeply aspossible3. Exhale to normal depth4. 3 normal breaths5. Exhale as much aspossible6. 3 normal breaths7. Inhale as much as possible8. Exhale as fast andcompletely as possible9. 4 normal breathsworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 7.  VOLUME OF GAS EXPIRED AND RATE ATWHICH THEY ARE EXPIRED ARE MEASURED PERMITS ASSESSMENT OF THOSE VOLUMESWHICH CAN BE VOLUNTARILY EXCHANGED ALL THE COMPONENTS OF TOTAL LUNGCAPACITY EXCEPT RV, FRC, AND TLC CAN BEMEASUREDworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 8. INTERPRETATION DEPENDS ONSOME FACTORS Normal values vary and depend on: Height Age Gender Ethnicityworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 9. REFERENCE STANDARDS PULMONARY FUNCTIONMEASUREMENTS ON CHILDRENWITHOUT RESPIRATORY DISEASE FORCOMPARISION TELL HOW LUNG FUNCTION SHOULDCHANGE OVER TIME WITH NORMALGROWTH GROWTH RELATED CHANGES IN PFTCORELATE BEST WITH HEIGHT world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 10. SPECIAL CONSIDERATION IN PAEDIATRICPATIENT ABILITY TO PERFORM SPIROMETRYDEPENDS ON DEVELOPMENTAL AGE OFCHILD , PERSONALITY, AND INTEREST OFTHE CHILD. PATIENT NEED A CALM , RELAXEDENVIRONMENT AND GOOD COACHING,PATIENCE IS THE KEY. EVEN WITH BEST ENVIRONMENT ANDCOACHING, A CHILD MAY NOT BE ABLETO PERFORM SPIROMETRY. world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 11. SPIROMETRY IN ASTHMAASPECTS OF LUNG FUNCTION MEASURED BYSPIROMETRY IN DETERMINING SEVERITYAND CONTROL OF ASTHMA :- FORCED VITAL CAPACITY –TOTAL AMOUNTOF AIR FORCEFULLY EXHALED AFTERMAXIMAL INSPIRATION FORCED EXPIRATORY VOLUME AT ONESECOND- AMOUNT OF AIR FORCEFULLYEXHALED AT ONE SECONDworld asthma week 2012Department of paediatrics FEHRCworld asthma week 2012 drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 12. FEV1 / FVC RATIO FEV1 / FVC IN NORMAL INDIVIDUALS –APPROX 85% RESTRICTIVE LUNG DISEASE – AIRFLOW ISREDUCED IN PROPORTION TO REDUCTIONIN LUNG VOLUME - FEV1 / FVC > 80% OBSTRUCTIVE LUNG DISEASE – AIRFLOW ISREDUCED MORE THAN LUNG VOLUME -FEV1 / FVC IS REDUCEDworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 13. A NORMAL FLOWVOLUME LOOPHAS A RAPIDPEAK EXPIRATORYFLOW RATE WITHA GRADUALDECLINE IN FLOWBACKTO ZERO.world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 14. OBSTRUCTIVE LUNG DISEASE Obstructive lungdisease changes theappearance of the flowvolume curve As with a normalcurve, there is a rapidpeak expiratoryflow, but the curvedescends more quicklythan normal and takeson a concave shapeworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 15. Normal Obstructionworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 16. The shape of the flowvolume loop is relativelyunaffected in restrictivedisease, but the overallsize of the curve willappear smaller whencompared to normals onthe same scale.world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 17. INTERPRETATION OF THE VALUESFVCInterpretation of % predicted: 80-120% Normal 70-79% Mild 50%-69% Moderate <49% Severeworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 18. INTERPRETATION FEV1 > 80% FEV1 60 – 79% FEV1 40 – 59% FEV1 <40% NORMAL MILD MODERATE SEVEREworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 19. INTERPRETATION OF VALUES FEF 25-75% Interpretation of %predicted: >79% Normal 60-79% Mildobstruction 40-59% Moderateobstruction <40% Severeobstruction FEV1/FVC Interpretation ofabsolute value: 80 or higher Normal 79 or lower Abnormalworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 20.  IF STILL IN DOUBT OF PATIENT HAVINGASTHMA, REPEAT THE TEST AFTERSHORT ACTING BRONCHODILATOR LIKESALBUTAMOL IMPROVEMENT IN FEV1 OF 12% ORMORE CONFIRMS DIAGNOSISworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 21. ROLE OF SPIROMETRY IN ASTHMA HELPS TO MAKE DIAGNOSIS ASSESS DEGREE OF AIRFLOW OBSTRUCTION TO PREDICT WHETHER OBSTRUCTION ISREVERSIBLE AIDS IN MANAGEMENT OF ASTHMA TO MONITOR PROGRESSION OF DISEASEworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 22. PEAK FLOW METRY MEASURES PEAK EXPIRATORY FLOWRATE (PEFR) DETECTS OBSTRUCTION IN LARGECENTRAL AIRWAYS ONLY NOT RECOMMENDED FOR ALLPATIENTS, USED ONLY IN THOSE WITHMODERATE TO SEVERE ASTHMAworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 23. INTERPRETATION PEF COMPARED TO PATIENT’S OWNPREVIOUS BEST MEASUREMENTS USINGHIS OWN PEAK FLOW METER IMPROVEMENT OF 60L/MIN OR >20% OFPRE BRONCHODILATOR PEFORDIURNAL VARIATION OF >20%world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 24. SUMMARY Spirometry is a reproducible and inexpensivetool in the management of asthma Spirometry is useful in the diagnosis ofasthma (demonstrations of reversibility) Spirometry measures both large and smallairways function and can be used to monitorpatients world asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC
  • 25. THANK YOUworld asthma week 2012drpankajyadav05@gmail.comDepartment of paediatrics FEHRC