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INTERPRETATION OF PULMONARY FUNCTION TESTS A.A. Eldawlatly  [email_address]
INDICATIONS <ul><li>Is a basic tool to evaluate the patient respiratory status. </li></ul><ul><li>It is often the first di...
Requirement for Good PFTs <ul><li>Adequate equipment </li></ul><ul><li>Reproducible performance </li></ul>
AMERICAN THORACIC SOCIETY (ATS) GUIDELINES FOR ACCEPTABILITY & REPRODUCIBILITY <ul><li>Criteria for acceptability </li></u...
Variable effort, cough, early glottic closure can be seen on the graph but not at the values of the FEV1 and FVC
INTERPRETING SPIROMETRY Normal flow/volume   Normal volume/time Acceptability
OBSTRUCTIVE LUNG DISEASE <ul><li>FEV1 reduced more than FVC with FEV1/FVC ratio <70-80%. </li></ul><ul><li>FEV1   >80%  No...
Example of spirometry with mild obstruction <ul><li>Variable  Means  Predicted  %Pred </li></ul><ul><li>FVC  2.63  3.11  8...
 
RESTRICTIVE LUNG DISEASE <ul><li>Both FEV1&FVC reduced proportionately </li></ul><ul><li>FEV1/FVC normal or elevated </li>...
 
UPPER AIRWAY OBSTRUCTION (UAO) <ul><li>Types </li></ul><ul><li>Variable extra thoracic obstruction ( VEO ): inspiratory st...
 
 
Mediastinal mass
Lack artifacts, start without hesitation, exhalation for 6 s
Examples
 
 
 
 
 
Example 1 <ul><li>Variable  means  predicted  %pred </li></ul><ul><li>FVC  2.62  2.82  93 </li></ul><ul><li>FEV1  1.45  1....
Example 2 <ul><li>Variable  Means  Predicted  %pred </li></ul><ul><li>FVC  2.20  2.58  85 </li></ul><ul><li>FEV1  1.79  1....
Example 3 <ul><li>Variable  Means  Predicted  %pred </li></ul><ul><li>FVC  5.08  4.94  103 </li></ul><ul><li>FEV1  2.66  3...
Example 4 <ul><li>Variable  Means  Predicted  %pred </li></ul><ul><li>FVC  1.85  4.60  40 </li></ul><ul><li>FEV1  0.92  3....
Example 5 <ul><li>Variable  Means  Predicted  %pred   </li></ul><ul><li>FVC  2.78  2.75  101 </li></ul><ul><li>FEV1  1.90 ...
Example 6 <ul><li>Variable  Means  Predicted  %pred   </li></ul><ul><li>FVC  2.78  2.75  101  </li></ul><ul><li>FEV1  1.90...
Example 7 <ul><li>Variable  Means  Predicted  %pred </li></ul><ul><li>FVC  3.66  4.39  83 </li></ul><ul><li>FEV1  1.03  2....
Example 8 <ul><li>Variable  Means  Predicted  %pr </li></ul><ul><li>FVC  3.66  3.54  103 </li></ul><ul><li>FEV1  2.30  2.7...
Example 9 <ul><li>Variable  Means  Predicted  %pred   </li></ul><ul><li>FVC  3.66  3.54  103 </li></ul><ul><li>FEV1  2.30 ...
Example 10 <ul><li>Variable  Means  Predicted  %pred   </li></ul><ul><li>FVC  4.09  4.25  96 </li></ul><ul><li>FEV1  1.95 ...
Example 11 <ul><li>Variable  Means  Predicted  %pred   </li></ul><ul><li>FVC  1.40  2.48  56 </li></ul><ul><li>FEV1  0.85 ...
Example 12 <ul><li>Variable  Means  predicted  %pred   </li></ul><ul><li>FVC  3.02  3.41  88 </li></ul><ul><li>FEV1  1.23 ...
<ul><li>THANK YOU </li></ul>
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Interpretation OF PFT

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Interpretation OF PFT

  1. 1. INTERPRETATION OF PULMONARY FUNCTION TESTS A.A. Eldawlatly [email_address]
  2. 2. INDICATIONS <ul><li>Is a basic tool to evaluate the patient respiratory status. </li></ul><ul><li>It is often the first diagnostic test employed in the work up. </li></ul><ul><li>Used for preoperative evaluation. </li></ul><ul><li>Used for managing patients with known pulmonary disease. </li></ul><ul><li>Used to quantify pulmonary disability. </li></ul>
  3. 3. Requirement for Good PFTs <ul><li>Adequate equipment </li></ul><ul><li>Reproducible performance </li></ul>
  4. 4. AMERICAN THORACIC SOCIETY (ATS) GUIDELINES FOR ACCEPTABILITY & REPRODUCIBILITY <ul><li>Criteria for acceptability </li></ul><ul><li>Lack of artifacts </li></ul><ul><li>Satisfactory start without hesitation </li></ul><ul><li>Satisfactory exhalation with 6 sec of smooth continuous exhalation </li></ul><ul><li>Criteria for reproducibility </li></ul><ul><li>Largest FVC within 0.2L of next largest FVC </li></ul><ul><li>Largest FEV1 within 0.2L of next largest FEV1 </li></ul><ul><li>If the two above not met, additional spirogram should be obtained </li></ul>
  5. 5. Variable effort, cough, early glottic closure can be seen on the graph but not at the values of the FEV1 and FVC
  6. 6. INTERPRETING SPIROMETRY Normal flow/volume Normal volume/time Acceptability
  7. 7. OBSTRUCTIVE LUNG DISEASE <ul><li>FEV1 reduced more than FVC with FEV1/FVC ratio <70-80%. </li></ul><ul><li>FEV1 >80% Normal </li></ul><ul><li>60-80% mild obstruction </li></ul><ul><li>50-65% moderate obstruction </li></ul><ul><li><50% severe obstruction </li></ul>
  8. 8. Example of spirometry with mild obstruction <ul><li>Variable Means Predicted %Pred </li></ul><ul><li>FVC 2.63 3.11 84 </li></ul><ul><li>FEV1 1.58 2.28 69 </li></ul><ul><li>FEV1/FVC 60 73 - </li></ul><ul><li>FEF25-75% 0.59 3.56 23 </li></ul><ul><li>PEF 4.9 5.78 85 </li></ul>
  9. 10. RESTRICTIVE LUNG DISEASE <ul><li>Both FEV1&FVC reduced proportionately </li></ul><ul><li>FEV1/FVC normal or elevated </li></ul><ul><li>Example: </li></ul><ul><li>Variable Means Predicted %Pred </li></ul><ul><li>FVC 0.96 2.75 35 </li></ul><ul><li>FEV1 0.94 1.90 49 </li></ul><ul><li>FEV1/FVC 98 69 - </li></ul><ul><li>FEF25-75% 2.25 2.11 107 </li></ul><ul><li>PEF 2.98 5.40 55 </li></ul>
  10. 12. UPPER AIRWAY OBSTRUCTION (UAO) <ul><li>Types </li></ul><ul><li>Variable extra thoracic obstruction ( VEO ): inspiratory stridor, vocal cord paralysis, tracheomalacia. </li></ul><ul><li>Variable intra thoracic obstruction ( VIO ): expiratory stridor, tracheomalacia, neoplasm </li></ul><ul><li>Mixed : tracheal stenosis, foreign body or </li></ul><ul><li>neoplasm </li></ul>
  11. 15. Mediastinal mass
  12. 16. Lack artifacts, start without hesitation, exhalation for 6 s
  13. 17. Examples
  14. 23. Example 1 <ul><li>Variable means predicted %pred </li></ul><ul><li>FVC 2.62 2.82 93 </li></ul><ul><li>FEV1 1.45 1.98 73 </li></ul><ul><li>FEV1/FVC 55 70 </li></ul><ul><li>FEF25-75% 0.43 2.20 20 </li></ul><ul><li>PEF 4.50 5.48 82 </li></ul>
  15. 24. Example 2 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 2.20 2.58 85 </li></ul><ul><li>FEV1 1.79 1.85 97 </li></ul><ul><li>FEV1/FVC 81 72 </li></ul><ul><li>FEF25-75% 1.82 2.23 82 </li></ul><ul><li>PEF 5.67 5.20 109 </li></ul>
  16. 25. Example 3 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 5.08 4.94 103 </li></ul><ul><li>FEV1 2.66 3.58 74 </li></ul><ul><li>FEV1/FVC 52 72 </li></ul><ul><li>FEF25-75% 1.40 3.47 40 </li></ul><ul><li>PEF 6.49 9.10 71 </li></ul>
  17. 26. Example 4 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 1.85 4.60 40 </li></ul><ul><li>FEV1 0.92 3.33 28 </li></ul><ul><li>FEV1/FVC 50 72 </li></ul><ul><li>FEF25-75% 0.28 3.28 9 </li></ul><ul><li>PEF 3.82 8.55 45 </li></ul>
  18. 27. Example 5 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 2.78 2.75 101 </li></ul><ul><li>FEV1 1.90 1.90 100 </li></ul><ul><li>FEV1/FVC 69 69 </li></ul><ul><li>FEF25-75% 0.95 2.35 40 </li></ul><ul><li>PEF 4.82 5.45 88 </li></ul>
  19. 28. Example 6 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 2.78 2.75 101 </li></ul><ul><li>FEV1 1.90 1.90 100 </li></ul><ul><li>FEV1/FVC 69 69 </li></ul><ul><li>FEF25-75% 0.95 2.35 40 </li></ul><ul><li>PEF 4.82 5.45 88 </li></ul>
  20. 29. Example 7 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 3.66 4.39 83 </li></ul><ul><li>FEV1 1.03 2.87 36 </li></ul><ul><li>FEV1/FVC 28 65 </li></ul><ul><li>FEF25-75% 0.33 2.48 13 </li></ul><ul><li>PEF 4.29 8.33 52 </li></ul>
  21. 30. Example 8 <ul><li>Variable Means Predicted %pr </li></ul><ul><li>FVC 3.66 3.54 103 </li></ul><ul><li>FEV1 2.30 2.77 83 </li></ul><ul><li>FEV1/FVC 63 78 </li></ul><ul><li>FEF25-75% 2.15 4.20 51 </li></ul><ul><li>PEF 2.39 6.25 38 </li></ul>
  22. 31. Example 9 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 3.66 3.54 103 </li></ul><ul><li>FEV1 2.30 2.77 83 </li></ul><ul><li>FEV1/FVC 63 78 </li></ul><ul><li>FEF25-75% 2.15 4.20 51 </li></ul><ul><li>PEF 2.39 6.25 38 </li></ul>
  23. 32. Example 10 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 4.09 4.25 96 </li></ul><ul><li>FEV1 1.95 2.88 68 </li></ul><ul><li>FEV1/FVC 48 68 </li></ul><ul><li>FEF25-75% 0.48 2.65 18 </li></ul><ul><li>PEF 6.27 8.06 78 </li></ul>
  24. 33. Example 11 <ul><li>Variable Means Predicted %pred </li></ul><ul><li>FVC 1.40 2.48 56 </li></ul><ul><li>FEV1 0.85 1.75 49 </li></ul><ul><li>FEV1/FVC 61 74 </li></ul><ul><li>FEF25-75% 0.37 2.11 18 </li></ul><ul><li>PEF 1.30 5.10 25 </li></ul>
  25. 34. Example 12 <ul><li>Variable Means predicted %pred </li></ul><ul><li>FVC 3.02 3.41 88 </li></ul><ul><li>FEV1 1.23 2.53 49 </li></ul><ul><li>FEV1/FVC 41 74 </li></ul><ul><li>FEF25-75% 0.41 2.77 15 </li></ul><ul><li>PEF 3.95 6.10 65 </li></ul>
  26. 35. <ul><li>THANK YOU </li></ul>

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