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BASIC PRINCIPLE ON BASIC PRINCIPLE ON LUNG FUNCTION TESTLUNG FUNCTION TEST
Prof.dr.Tamsil Syafiuddin, SpP(K)
Tingkat kemampuan menurut Piramid Miller :
Tingkat kemampuan 1:Mengetahui dan Menjelaskan
Tingkat kemampuan 2:Pernah Melihat atau pernah didemonstrasikan
Tingkat kemampuan 3:Pernah melakukan atau pernah menerapkan di bawah supervisi
Tingkat kemampuan 4:Mampu melakukan secara mandiriStandar Kompetensi Dokter, Konsil Kedokteran Indonesia, 2006
Diagnostic procedures
Lung function tests/spirometry -1- -2- -3- -4-Histamine provocation test -1- -2- -3- -4-Allergy tests -1- -2- -3- -4-Hyperventilation provocation test -1- -2- -3- -4-Perfusion/ventilation scan -1- -2- -3- -4-Bronchoscopy -1- -2- -3- -4-
Standar Kompetensi Dokter, Konsil Kedokteran Indonesia, 2006
INTRODUCTION
The function of lung is for gas exchange
Respiration is to allow oxygen to move
from the air into the venous blood and
carbon dioxide to move out
RESPIRATION
Ventilation
Diffusion
Perfusion
VENTILATION
Lung volume
Static lung volume
Dynamic lung volumeSpirometry
SPIROMETRY
( To Spir = Bernapas )
SPIROMETRY
Measurement of Lung volume
Simple
Easy to perform
Reliable
SPIROMETRY
Sensitive
Accurate
Reproducible
SPIROMETRY
ATS recommendation :
3 acceptable
2 reproducible
Maximal 8 maneuver
SPIROMETRY
Good preparation
Good maneuver
Accurate result
Garbage in – garbage out
The new spirometri = Dynamic lung volume
• Flow Obtructive Obstructive
• Volume Restrictive Restrictive
5
6
4
3
2
1
0
FEV1 FVC
1 2 3 4 5 6
Time (sec)
Vol
ume
(lit
ers)
Fig . Normal forced expiration curve
Obstructive FEV1
FVCRestrictive
Static Lung Volume
Vt
IRV
IC
ERV
RV
VC
FRC
ECVt
IRV
IC
ERV
RV
VC
FRC
ECVt
IRV
IC
ERV
RV
VC
FRC
EC
TV 0,5
IRV 3,0
ERV 1,3
RV 1,2
IC 3,5
VC 4,8
FRC 2,5
TLC 6,0
Tab. 1. Static ventilatory
parameters in litres.
RESTRICTION
VC < 80% VC predicted
OBSTRUCTION
FEV1 < 75%
FVC
FEV1 < 80% FEV1 predicted
PEAK FLOW METER
Serial measurement
Restriction / obstruction
LUNG FUNCTION TEST
1. To establish diagnosis
LUNG FUNCTION TEST
2. To evaluate treatment
LUNG FUNCTION TEST
3. To monitor the nature of disease
LUNG FUNCTION TEST
4. To determine the degree of disability
LUNG FUNCTION TEST
5. To determine the prognosis
RESIDUAL VOLUME
I. Helium equilibrium
~ Open circuit method
~ Close circuit method
II. Body plethysmograph
FLOW – VOLUME CURVE
Maneuver
Additional information
VENTILATION SCANNING
Using radioactive gas
Xenon
Argon
DIFFUSION
DLCO
Single breath method
Rebreathing method
PERFUSION
Dye dilusion
Perfusion scanning
CONCLUSION
Lung function test give information
about the disease Spirometry is a simple method to
measure ventilation Good preparation and good maneuver
is important Serial measurement is necessary
Recommended