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Pulmonary Function Tests
Pulmonary Function Tests
Pulmonary Function Tests
L
Asst. Professor,
Dept. of Physiology,
SSMC, Tumkur
Importance of PFT
• Degree of impairment
• Evaluation of treatment
Classification of PFTs
I. Tests to assess ventilatory function:
1. Elastic Properties
a) Lung volume
i) Spirometry
ii) Body Plethysmography
iii) Gas Dilution
b) Elastic Resistance of Lungs
c) Elastic Resistance of Chest Wall
d) Elastic Resistance of Lung + Chest Wall
2. Airway Function
a) Airway Resistance
b) Forced Vital Capacity
c) Maximum Voluntary Ventilation
d) Post bronchodilator Studies
e) Airway Provocation
3. Respiratory Muscle Function
II. Tests to assess blood & gas
distribution and of gas exchange:
1. Intrapulmonary Gas Distribution
a) Multiple-Breath Dilution Techniques
b) Single-Breath Dilution Techniques
c) Frequency Dependence of Compliance
2. Pulmonary Blood Flow Distribution
3. Diffusion
a) Steady-State CO Diffusing Capacity
b) Single-Breath CO Diffusing Capacity
c) Pulmonary Capillary Blood
4. Assessment of Gas Exchange
a) Blood & Gas Sampling & Analysis
b) Calculation of Parameters of Gas
Exchange
i) O2 Consumption
ii) CO2 Production
iii) Respiratory Quotient
iv) Physiologic Dead Space
5. Acid-Base Status
6. Response to Exercise
7. Chemical Regulation of Respiration
Assessment of ventilation
1. ELASTIC PROPERTIES OF LUNG:
b) Lung volumes & capacities-
Measured using (i) Spirometer,
(ii) Plethysmograph, (iii) Gas dilution
techniques
Spirogram
Lung Volumes:
• Tidal Volume
• Inspiratory Reserve Volume
• Expiratory Reserve Volume
• Residual Volume
Lung Capacities:
• Inspiratory Capacity
• Functional Residual Capacity
• Vital Capacity
• Total Lung Capacity
Body Plethysmography:
• Based on Boyle’s Law
• P1 x TGV = (P1 + ΔPm) (TGV + ΔVp) where
P1- initial pressure
ΔPm- mouth or airway pressure
ΔVp- volume in box
TGV- Thoracic Gas Volume
Gas Dilution:
Insoluble gases like helium, hydrogen or nitrogen
is used.
FRC, RV and TLC can be measured.
iv) Multiple breath Helium Technique
FRC = (VS + VDS) (FIHE – FEHE)
FEHE
Where VS- initial vol of gas in spirometer
VDS- dead space of the system
FIHE- initial He concentration
FEHE- He conc at equilibrium
ii) Single-Breath Helium Technique
TLC x FEHE = (VC x FIHE) + (RV x FOHE)
Where TLC- total lung capacity
VC- vital capacity
RV- residual volume
FEHE- He conc at equilibrium
FIHE- initial He concentration
FOHE- He conc in lungs at onset of
inspiration
iii) Multiple-Breath N2 washout
Closed circuit 100% O2 breathing for 7mins
iv) Single-Breath N2 Clearance
80
N2 conc (%)
30
20
CV RV TLC
10 30%
VC
0
1 2 3 4 5 6
Volume (L)
RV
Vital Capacity
b) Elastic Resistance of lung
i) Transpulmonary Pressure
ii) Airflow & Volume- using
pneumotachogram and spirometer
iii) Compliance of lung- Static & Dynamic
7. Response to exercise
Interpretation of PFT
Interpretation of ventilatory function tests:
• Lung volume compartments differ with
age, gender, race and height
• Lung volume and capacity measurements
give an idea about restrictive & obstructive
disorders.
• Reduced FRC, RV & TLC volume-
pressure curve shifted to right &
downwards reduced compliance of lung
and/or chest wall
• Increased FRC, RV & TLC
overdistension volume-pressure curve
shifted to left and upwards obstructive
airway disease
RESTRICTIVE
PATTERN
6 5 4 3 2 1 0
IC ERV RV
OBSTRUCTIVE
PATTERN
0
6 5 4 3 2 1 0 Lung volume (L)
• FEF25-75 and FEV1 may be normal in
increased peripheral airway resistance.