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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

RES 131

Pulmonary Functions

good start of test
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
no coughing
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
no variable flow
No Variable Flow

Flow rate should be maximal and consistent throughout testing

Volume-Time and Flow-Volume tracings should be smooth

no early termination of effort
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
reproducibility
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.
temperature correction
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
temperature correction13
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
temperature correction14
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)
temperature correction15
Temperature Correction
  • Formula for calculation of temperature correction factor
temperature correction16
Temperature Correction
  • Conversion factor is multiplied by the ATPS volume to find the BTPS volume.
back extrapolation
Back Extrapolation
  • Extrapolated Volume may not exceed 5% of the FVC
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