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RES 131

RES 131. Pulmonary Functions. Good Start of Test. Start of test must be quick and forceful No excessive hesitation Best evaluated using the Flow-Volume tracing No excessive back extrapolated volume. Good Start of Test. No Coughing. Especially during the first 1 second of the maneuver

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RES 131

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  1. RES 131 Pulmonary Functions

  2. Good Start of Test • Start of test must be quick and forceful • No excessive hesitation • Best evaluated using the Flow-Volume tracing • No excessive back extrapolated volume

  3. Good Start of Test

  4. No Coughing • Especially during the first 1 second of the maneuver • Best if no coughing present during maneuver, however: • Some patients cough near the end of each test, if present then document

  5. No Coughing

  6. No Variable Flow Flow rate should be maximal and consistent throughout testing Volume-Time and Flow-Volume tracings should be smooth

  7. No Variable Flow

  8. No Early Termination of Effort • Best if maneuver lasts at least six (6) seconds • Less than six seconds acceptable if a plateau of al least one (1) second is present • If patient is unable to meet the above criteria, document in comment section

  9. No Early Termination of Effort

  10. Reproducibility • Spirometry induced bronchospasm • Each effort gets worse • Patient eventually reaches a plateau, however they may be too short of breath to continue. • Which effort to report? • Best effort unless pre and post bronchodilator study, then report the worst effort.

  11. Spirometry Induced Bronchospasm

  12. Temperature Correction • Charles law states that the volume occupied by a given quantity of gas is directly related to temperature • Body temperature gas is exhaled into a room temperature spirometer, therefore the volume decreases • Temperature correction allows us to know the volume of gas as it was in the body

  13. Temperature Correction • Charles law states that the volume occupied by a given quantity of gas is directly related to temperature • Body temperature gas is exhaled into a room temperature spirometer, therefore the volume decreases • Temperature correction allows us to know the volume of gas as it was in the body

  14. Temperature Correction • The volume measured by the spirometer is reflected at ATPS (atmospheric temperature, pressure, saturated) • It must be corrected to BTPS (body temperature, pressure, saturated)

  15. Temperature Correction • Formula for calculation of temperature correction factor

  16. Temperature Correction • Conversion factor is multiplied by the ATPS volume to find the BTPS volume.

  17. Back Extrapolation • Extrapolated Volume may not exceed 5% of the FVC

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