Pulmonary Function Tests (PFT)

PULMONARY FUNCTION TESTS (PFT)
Anatomy
Lungs comprised of
Airways Alveoli
http://www.aduk.org.uk/gfx/lungs.jpg
The Airways
Conducting zone: no gas exchange occurs Anatomic dead space Respiratory zone: contain the alveolar sacs
The Alveoli

Approximately 300 million alveoli 1/3 mm diameter Total surface area if they were complete spheres 85 sq. meters (size of a tennis court)
Mechanics of Breathing

Inspiration
Active process
Expiration
Quiet breathing: passive Can become active
Pulmonary Function Tests
Evaluates 1 or more major aspects of the respiratory system

Assessment and diagnosis of pulmonary disease Evaluate extent and monitor course of disease Aid in determining of the necessary course of treatment Lung volume and air flow rate
Respiratory Function Test

Static lung functions volumes Dynamic lung functions volume and velocity
Spirometry
Measurement of the pattern of air movement into and out of the lungs during controlled ventilatory maneuvers.
Factors That Affect Lung Volumes

Age Sex Height Weight Race Disease
Static lung functions
Lung Volumes
IRV TV ERV IC VC TLC
4 Volumes 4 Capacities
Sum of 2 or more lung volumes
FRC
RV RV
Tidal Volume (TV)
IRV TV ERV
IC VC TLC
Volume of air inspired and expired during normal quiet breathing (0.5L)
FRC
RV RV
Inspiratory Reserve Volume (IRV)
IRV TV ERV
IC VC TLC
FRC
RV RV
The maximum amount of air that can be inhaled after a normal tidal volume inspiration (2.5-3.5 L)
Expiratory Reserve Volume (ERV)
IRV TV ERV
IC VC TLC
FRC
RV
Maximum amount of air that can be exhaled from the resting expiratory level 1.0 L
RV
Residual Volume (RV)
IRV TV ERV
IC VC TLC
Volume of air remaining in the lungs at the end of maximum expiration
FRC
RV RV
Vital Capacity (VC)
IRV TV ERV
IC VC TLC
Volume of air that can be exhaled from the lungs after a maximum inspiration VC = IRV + TV + ERV
FRC
RV RV
Inspiratory Capacity (IC)
IRV TV ERV
IC VC TLC
The amount of air that the lung will hold after normal expiration IC = IRV + TV
FRC
RV RV
Functional Residual Capacity (FRC)
IRV TV ERV
IC VC TLC
Volume of air remaining in the lungs at the end of a TV expiration FRC = ERV + RV
FRC
RV RV
Total Lung Capacity (TLC)
IRV TV ERV
IC VC TLC
Volume of air in the lungs after a maximum inspiration TLC = IRV + TV + ERV + RV
FRC
RV RV
Dynamic Functions
Dynamic Functions
SVC (slow vital capacity) Lung volume measured from complete expiration following deep inspiration
Dynamic Functions
M V V (maximum voluntary ventilation) Maximum volume of air which can be moved on expiration while breathing as deeply and as rapidly as possible.
Dynamic Functions
MV (minute ventilation) Volume of expired air in liters per minute measured over a minimum of one minute.
Dynamic Functions
Forced vital capacity (FVC):
Total volume of air that can be exhaled forcefully (quickest exhalation) after maximum inhalation ( from TLC) The majority of FVC can be exhaled in <3 seconds in normal people, but often is much more prolonged in obstructive diseases
Terminology
Forced expiratory volume in 1 second: (FEV1)
Volume of air forcefully expired from full inflation (TLC) in the first second Measured in liters (L) Normal people can exhale more than 75-80% of their FVC in the first second; thus the FEV1/FVC can be utilized to characterize lung disease
FVC
Interpretation of % predicted:
80-120% 70-79% 50%-69% <50%
Normal Mild reduction Moderate reduction Severe reduction
FVC
FEV1
Interpretation of % predicted:
75%-80% 69% or lower 88-90% or higher
Normal obstruction restrictive
FEV1
FVC
In patients with obstructive diseases, the lung's air volume will be more slowly expelled and will be a smaller volume over the time course of the FVC test than would be expected in a normal, healthy individual. In patients with restrictive lung disease, the FVC will be smaller because the amount of air that can be forcefully inhaled or exhaled from the lungs is smaller to start with because of disease. This may be due to the fact that thoracic cage does not have the ability to expand very much.
Technique
Have patient seated comfortably Closed-circuit technique
Place nose clip on Have patient breathe on mouthpiece Have patient take a deep breath as fast as possible Blow out as hard as they can until you tell them to stop

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PULMONARY FUNCTION TESTS (PFT)

Pulmonary Function Tests

Evaluates 1 or more major aspects of the respiratory system

Respiratory Function Test

Factors That Affect Lung Volumes

Static lung functions

IRV TV ERV IC VC TLC

Sum of 2 or more lung volumes

Tidal Volume (TV)

Inspiratory Reserve Volume (IRV)

Expiratory Reserve Volume (ERV)

Residual Volume (RV)

Volume of air remaining in the lungs at the end of maximum expiration

Vital Capacity (VC)

Inspiratory Capacity (IC)

Functional Residual Capacity (FRC)

Total Lung Capacity (TLC)

Forced vital capacity (FVC):

Forced expiratory volume in 1 second: (FEV1)

80-120% 70-79% 50%-69% <50%

Normal Mild reduction Moderate reduction Severe reduction

75%-80% 69% or lower 88-90% or higher

Normal obstruction restrictive

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