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PULMONARY FUNCTION
TESTS
KHAZI ABDUL JABBAR
DEPT. OF OCCUPATIONAL DISEASES,
MEDICAL ACADEMY named after S. I. GEORGIEVSKY,
CRIMEAN FEDERAL UNIVERSITY.
LEARNING OBJECTIVES:
 General purpose for PFTs
 Types of PFTs
 Interpretation of different PFTs
 Knowing normal PFTs
PURPOSE OF PFTs:
 Dx of symptomatic disease.
 Early screening for asymptomatic diseases.
 Prediction of prognosis.
 Monitoring of treatment.
PFTs helps us to classify diseases
into 3 major subdivisions:
 Obstructive lung disease:
COPD, BA, CF & bronchiectasis.
 Restrictive lung disease:
interstitial lung diseases (pulmonary fibrosis,
sarcoidosis), chest wall pathologies, neuromuscular
pathologies (ALS).
 Pulmonary vascular disease:
primary pulmonary hypertension, ch. TED.
TYPES OF PFTs:
 Routine: spirometry, lungs volume, diffusing capacity of
CO-(abb:Dlco)
 Specialized: arterial blood gas, oximetry, peak flow,
exercise tests.
General understanding of lungs
volumes:
SPIROMETRY:
 How it is done?
Values that we will be
calculating:
Flow volume loop:
Summary of values:
 FEV1:>3 L
 FVC:>4 L
 FEV1/FVC ratio: 60%
 Flow volume loop
 PERF: male(((ht*5.48)+1.58)-(age*0.041))*60
female(((ht*3.72)+2.24)-(age*0.03))*60
 FEF25-75%
 With bronchodilator:
Interpretation of spirometry:
FEV1 FVC
FEV1/FVC
RATIO
Tiffeneau
Index.
OLD
NORM/
DECREASED
NORM/
DECREASED
DECREASED
(<70%)
RLD
NORM/
DECREASED
DECREASED INCREASED
(>70%)
Flow volume loop:
Location of obstruction:
Stagine of COPD based on FEV1:
GOLD classification based on FEV1 post
bronchodilation.
GOLD STAGES FEV1 as per age/sex/height
1ST STAGE FEV1≥70%
2ND STAGE FEV1 ≤50 TO <80%
3RD STAGE FEV1 ≤30 TO <50%
4TH STAGE FEV1 <30%
LUNGS VOLUME TESTS:
 Gas dilution methods- helium & nitrogen.
 Body plethysmography.
 Radiographic measurement.
Gas dilution test:
Imagine techniques:
 From CXR measurements of lungs in PA & lateral views
can be entered in algorithm to estimate lung volume.
 Chest CT sliced section area multiplied with thickness
can give probable volume of lung.
 This type of technique is not accurate.
Interpretation of lung volumes:
DLCO:
 It is used to measure the capacity of lungs to exchange
gas.
 A gas mixture of 0.3% carbon monoxide is used. Px is
asked to take a breath & hold for about 10 sec & then
exhale.
 Helium is also add in test gas to measure the amount of
lung volume used during gaseous exchange.
Summary:
Case:
Probable dx: ILD, most likely hypersensitivity
pneumonitis.
END.
ANY QUESTIONS?

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Khazi abdul jabbar

  • 1. PULMONARY FUNCTION TESTS KHAZI ABDUL JABBAR DEPT. OF OCCUPATIONAL DISEASES, MEDICAL ACADEMY named after S. I. GEORGIEVSKY, CRIMEAN FEDERAL UNIVERSITY.
  • 2. LEARNING OBJECTIVES:  General purpose for PFTs  Types of PFTs  Interpretation of different PFTs  Knowing normal PFTs
  • 3. PURPOSE OF PFTs:  Dx of symptomatic disease.  Early screening for asymptomatic diseases.  Prediction of prognosis.  Monitoring of treatment.
  • 4. PFTs helps us to classify diseases into 3 major subdivisions:  Obstructive lung disease: COPD, BA, CF & bronchiectasis.  Restrictive lung disease: interstitial lung diseases (pulmonary fibrosis, sarcoidosis), chest wall pathologies, neuromuscular pathologies (ALS).  Pulmonary vascular disease: primary pulmonary hypertension, ch. TED.
  • 5. TYPES OF PFTs:  Routine: spirometry, lungs volume, diffusing capacity of CO-(abb:Dlco)  Specialized: arterial blood gas, oximetry, peak flow, exercise tests.
  • 6. General understanding of lungs volumes:
  • 8. Values that we will be calculating:
  • 10. Summary of values:  FEV1:>3 L  FVC:>4 L  FEV1/FVC ratio: 60%  Flow volume loop  PERF: male(((ht*5.48)+1.58)-(age*0.041))*60 female(((ht*3.72)+2.24)-(age*0.03))*60  FEF25-75%  With bronchodilator:
  • 11. Interpretation of spirometry: FEV1 FVC FEV1/FVC RATIO Tiffeneau Index. OLD NORM/ DECREASED NORM/ DECREASED DECREASED (<70%) RLD NORM/ DECREASED DECREASED INCREASED (>70%)
  • 14. Stagine of COPD based on FEV1: GOLD classification based on FEV1 post bronchodilation. GOLD STAGES FEV1 as per age/sex/height 1ST STAGE FEV1≥70% 2ND STAGE FEV1 ≤50 TO <80% 3RD STAGE FEV1 ≤30 TO <50% 4TH STAGE FEV1 <30%
  • 15. LUNGS VOLUME TESTS:  Gas dilution methods- helium & nitrogen.  Body plethysmography.  Radiographic measurement.
  • 17.
  • 18.
  • 19. Imagine techniques:  From CXR measurements of lungs in PA & lateral views can be entered in algorithm to estimate lung volume.  Chest CT sliced section area multiplied with thickness can give probable volume of lung.  This type of technique is not accurate.
  • 21. DLCO:  It is used to measure the capacity of lungs to exchange gas.  A gas mixture of 0.3% carbon monoxide is used. Px is asked to take a breath & hold for about 10 sec & then exhale.  Helium is also add in test gas to measure the amount of lung volume used during gaseous exchange.
  • 23. Case:
  • 24.
  • 25. Probable dx: ILD, most likely hypersensitivity pneumonitis.