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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Spirometry and peak flow metry in bronchial asthma
1. WORLD ASTHMA DAY 2012
YOU CAN CONTROL YOUR ASTHMA
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
2. SPIROMETRY AND PEAK FLOMETRY
IN
BRONCHIAL ASTHMA
Presented by
Dr. PANKAJYADAV
drpankajyadav05@gmail.com
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
3. SPIROMETRY IS A PULMONARY FUNCTIONTESTTHAT
MEASURESTHE VOLUME OF AIR AN INDIVIDUAL
INHALES OR EXHALES AS A FUNCTION OF TIME.
SPIROMETRY MEASURES HOW MUCH AND HOW
QUICKLYAIR CAN BE EXPELLED FOLLOWING A DEEP
BREATH.
FLOW , ORTHE RATE ATWHICHVOLUME IS CHANGING
ASA FUNCTION OFTIME, CAN ALSO BE MEASURED
WITH SPIROMETRY.
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
WHAT IS SPIROMETRY ?
4. EARLIEST SPIROMETRIC MEASUREMENT OF LUNG
VOLUMES AND ITS EXPIRABLE COMPONENTS WAS
DONE BY HUTCHINSON IN 1846
EQUIPMENT FORTESTING CHILDREN SHOULD BE
CAPABLE OF MEASURING SMALLVOLUMES AND LOW
FLOWS
CAN BE PERFORMED BYTHE AGE OF 3YEARS
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
6. Method – how to perform
1. 4 normal breaths
2. Inhale as deeply as
possible
3. Exhale to normal depth
4. 3 normal breaths
5. Exhale as much as
possible
6. 3 normal breaths
7. Inhale as much as possible
8. Exhale as fast and
completely as possible
9. 4 normal breaths
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
7. VOLUME OF GAS EXPIRED AND RATE AT
WHICH THEY ARE EXPIRED ARE MEASURED
PERMITS ASSESSMENT OF THOSE VOLUMES
WHICH CAN BE VOLUNTARILY EXCHANGED
ALL THE COMPONENTS OF TOTAL LUNG
CAPACITY EXCEPT RV, FRC, AND TLC CAN BE
MEASURED
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
8. INTERPRETATION DEPENDS ON
SOME FACTORS
Normal values vary and depend on:
Height
Age
Gender
Ethnicity
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
9. REFERENCE STANDARDS
PULMONARY FUNCTION
MEASUREMENTS ON CHILDREN
WITHOUT RESPIRATORY DISEASE FOR
COMPARISION
TELL HOW LUNG FUNCTION SHOULD
CHANGE OVER TIME WITH NORMAL
GROWTH
GROWTH RELATED CHANGES IN PFT
CORELATE BEST WITH HEIGHT world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
10. SPECIAL CONSIDERATION IN PAEDIATRIC
PATIENT
ABILITY TO PERFORM SPIROMETRY
DEPENDS ON DEVELOPMENTAL AGE OF
CHILD , PERSONALITY, AND INTEREST OF
THE CHILD.
PATIENT NEED A CALM , RELAXED
ENVIRONMENT AND GOOD COACHING,
PATIENCE IS THE KEY.
EVEN WITH BEST ENVIRONMENT AND
COACHING, A CHILD MAY NOT BE ABLE
TO PERFORM SPIROMETRY. world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
11. SPIROMETRY IN ASTHMA
ASPECTS OF LUNG FUNCTION MEASURED BY
SPIROMETRY IN DETERMINING SEVERITY
AND CONTROL OF ASTHMA :-
FORCED VITAL CAPACITY –TOTAL AMOUNT
OF AIR FORCEFULLY EXHALED AFTER
MAXIMAL INSPIRATION
FORCED EXPIRATORY VOLUME AT ONE
SECOND- AMOUNT OF AIR FORCEFULLY
EXHALED AT ONE SECOND
world asthma week 2012
Department of paediatrics FEHRCworld asthma week 2012 drpankajyadav05@gmail.com
Department of paediatrics FEHRC
12. FEV1 / FVC RATIO
FEV1 / FVC IN NORMAL INDIVIDUALS –
APPROX 85%
RESTRICTIVE LUNG DISEASE – AIRFLOW IS
REDUCED IN PROPORTION TO REDUCTION
IN LUNG VOLUME - FEV1 / FVC > 80%
OBSTRUCTIVE LUNG DISEASE – AIRFLOW IS
REDUCED MORE THAN LUNG VOLUME -
FEV1 / FVC IS REDUCED
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
13. A NORMAL FLOW
VOLUME LOOP
HAS A RAPID
PEAK EXPIRATORY
FLOW RATE WITH
A GRADUAL
DECLINE IN FLOW
BACKTO ZERO.
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
14. OBSTRUCTIVE LUNG DISEASE
Obstructive lung
disease changes the
appearance of the flow
volume curve
As with a normal
curve, there is a rapid
peak expiratory
flow, but the curve
descends more quickly
than normal and takes
on a concave shape
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
16. The shape of the flow
volume loop is relatively
unaffected in restrictive
disease, but the overall
size of the curve will
appear smaller when
compared to normals on
the same scale.
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
17. INTERPRETATION OF THE VALUES
FVC
Interpretation of % predicted:
80-120% Normal
70-79% Mild
50%-69% Moderate
<49% Severe
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
18. INTERPRETATION
FEV1 > 80%
FEV1 60 – 79%
FEV1 40 – 59%
FEV1 <40%
NORMAL
MILD
MODERATE
SEVERE
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
19. INTERPRETATION OF VALUES
FEF 25-75%
Interpretation of %
predicted:
>79% Normal
60-79% Mild
obstruction
40-59% Moderate
obstruction
<40% Severe
obstruction
FEV1/FVC
Interpretation of
absolute value:
80 or higher Normal
79 or lower Abnormal
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
20. IF STILL IN DOUBT OF PATIENT HAVING
ASTHMA, REPEAT THE TEST AFTER
SHORT ACTING BRONCHODILATOR LIKE
SALBUTAMOL
IMPROVEMENT IN FEV1 OF 12% OR
MORE CONFIRMS DIAGNOSIS
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
21. ROLE OF SPIROMETRY IN ASTHMA
HELPS TO MAKE DIAGNOSIS
ASSESS DEGREE OF AIRFLOW OBSTRUCTION
TO PREDICT WHETHER OBSTRUCTION IS
REVERSIBLE
AIDS IN MANAGEMENT OF ASTHMA
TO MONITOR PROGRESSION OF DISEASEworld asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
22. PEAK FLOW METRY
MEASURES PEAK EXPIRATORY FLOW
RATE (PEFR)
DETECTS OBSTRUCTION IN LARGE
CENTRAL AIRWAYS ONLY
NOT RECOMMENDED FOR ALL
PATIENTS, USED ONLY IN THOSE WITH
MODERATE TO SEVERE ASTHMA
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
23. INTERPRETATION
PEF COMPARED TO PATIENT’S OWN
PREVIOUS BEST MEASUREMENTS USING
HIS OWN PEAK FLOW METER
IMPROVEMENT OF 60L/MIN OR >20% OF
PRE BRONCHODILATOR PEF
OR
DIURNAL VARIATION OF >20%
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
24. SUMMARY
Spirometry is a reproducible and inexpensive
tool in the management of asthma
Spirometry is useful in the diagnosis of
asthma (demonstrations of reversibility)
Spirometry measures both large and small
airways function and can be used to monitor
patients world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC
25. THANK YOU
world asthma week 2012
drpankajyadav05@gmail.com
Department of paediatrics FEHRC