Spirometry at Laverty Pathology · Spirometry is the lung function test of choice for both...

Evaluation of lung function is important in many clinical scenarios, both when the patient has a history or symptoms suggestive of pulmonary disease, and in the presence of risk factors for lung disease e.g. cigarette smoking.

What is Spirometry? • Spirometry is the most commonly performed and

useful lung function test.• Itincludesmeasurementofforcedexpiratoryvolumein

one second (FEV1) and forced vital capacity (FVC).• Spirometry is readily available, simple toperformand

carries low risk to the patient.

Why Order Spirometry?• Recommended by the National Asthma CouncilAustralia,AustralianLungFoundationandtheThoracicSociety of Australia and New Zealand for diagnosisand management of asthma and chronic obstructive pulmonary disease (COPD)

• Rapid and objective detection of airflow obstruction,restriction of lung volumes and assessment of severity of impairment

• Quantitativeassessmentofresponsetotherapy

• Moreaccurateandreproducibleasameasureofairflowobstructionthanmeasurementofpeakflow

• AllowsdifferentiationbetweenasthmaandCOPD

• Mayassistinearlydetectionandmonitoringofdiseaseprogression in COPD

• Identification of airflow obstruction may offerencouragement and motivation for patients to quit smoking

• Observation of ventilatory changes by spirometryprovides patient feedback regarding their disease and effectofmedication

Advantages of Spirometry• Safe

• Most patients tested are able correctly to performtesting procedures

• Reproducible

• Quick:10-15minutestoperform

• Immediateavailabilityofresults

• Standardised performance requirements and testingmethods

• Comparison of patient results withwell characterisednormal reference values

Measurement of ventilatory function is part of routine assessment of respiratory disease. Spirometry is the lung function test of choice for both diagnosis and serial assessment of obstructive airways disease.

The aim of spirometry in general practice is to assess variability of airflow obstruction, and to measure the degree of airflow obstruction compared with predicted normal values.

Current clinical practice guidelines recommend that all doctors managing asthma and COPD should have access to and use a spirometer for optimal assessment of lung function.

Most adults and children over 7 years of age can perform spirometry.

At Laverty Pathology, we offer accurate spirometry conforming to international standards, performed by experienced technicians, and reported by specialist physicians.

Spirometry at Laverty Pathology Accurate measurement of ventilatory function is now more accessible.

60WaterlooRd,NorthRydeNSW2113.Telephone:(02)90057000 www.laverty.com.au

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Spirometry at Laverty PathologyAccurate measurement of ventilatory function is now more accessible. Continued

Spirometry at Laverty Pathology Qualityspirometryisnowavailableinmostofourcollection centres. • Accuratespirometersthatmeetappropriate

international standards• Dailycalibrationchecks• Trainedandexperiencedoperators• Activecoachingtoensurethepatientperforms

the test correctly• Ongoingqualityassurance• Reviewedandreportedbyspecialistphysicians• Bulkbilling

When to Order?• Evaluationofpatientswithrespiratorysymptomse.g.dyspnoea,cough,wheeze,exertionalcoughorchestpain

• Evaluationofpatientsatriskofrespiratorydiseasese.g.smokers,occupationalexposure,familyhistory

• Measurementoftheseverityofrespiratoryimpairment• Distinguishingbetweenrestrictivediseaseand

obstructive airways disease

• Objectiveassessmentofresponsetobronchodilatortherapy

• Riskevaluationofpatientspriortosurgerye.g.patientswith known COPD or asthma, current smokers, and those scheduled for thoracic or upper abdominal surgery

Contraindications to spirometryItisnotsafetoperformspirometryonpatientswhohavehadthefollowing:• Recenteye,thoracicorabdominalsurgery• Recentmyocardialinfarction• Aneurysmse.g.cerebral,aortic• Haemoptysisofunknowncause• Pneumothorax

How to Order• Request“Spirometry”• Forasthma/COPDpatients:request“Pre/post-bronchodilatorspirometry”

• Pleaseensurepatientsbringtheirownbronchodilatorsfor testing

• Enquiries: NickDelBaglivo,0290057039.

Definitions of Common Spirometric Indices

• FVC (ForcedVital Capacity) is themaximumvolumeof air that canbe expiredduring a single expiratorymanoeuvreusingmaximaleffortinitiatedfollowingafullinspiration.

• FEV1 (ForcedExpiredVolumeinonesecond) isthevolumeofairthatcanbeforcefullyexpiredinthefirstsecondoftheFVCmanoeuvre.Itisameasureofhowquicklyfulllungscanbeemptied.TheFEV1expressedasapercentofthepredictedvalueisusedtogradetheseverityofairflowobstruction.

• SVC (SlowVitalCapacity)isthemaximumvolumeofairthatcanbeexhaled“slowly”followingafullinspiration.TheSVCissimilartotheFVCinsubjectswithoutairflowobstruction,butisoftenlargerinsubjectswithairflowobstruction.

• FEV1/FVC ratio is theFEV1expressedasa fraction (orpercentage)of theFVCandgivesaclinicallyusefulindicatorofthepresenceofairflowobstruction.

• FEF25–75% (Forced Expiratory Flowbetween 25 and 75 percent of the FVC) is the average expired flowoverthemiddlehalfoftheFVCmanoeuvre.Itmayrepresentamoresensitivebutmorevariablemeasureofnarrowing of the smaller airways than provided by FEV1.

• PEF (PeakExpiratoryFlow)isthelargestexpiratoryflowachievedduringtheFVCmanoeuvre.

Available at most Laverty Collection Centres | Spirometry is BULK Billed | Specialist reviews & reports

60WaterlooRd,NorthRydeNSW2113.Telephone:(02)90057000 www.laverty.com.au

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