Download [= capacité vitale (forcée)] SPIROMETRY

SPIROMETRY
Blow to know
Dr.Johan Buffels
Belgian Primary Care
Respiratory Group
BPCRG
Belgian Primary Care
Respiratory Group
 Domus Medica (wetenschappelijke
vereniging van vlaamse huisartsen)
 Société Scientifique de Médecine
Générale
 University Departments of General
Practice

What is Spirometry?






a simple and safe test
that measures lung volumes
with a graphical display
gives an estimation of lung function
Allows for diagnosis of
airflow obstruction
Permits good follow-up
for asthma and COPD
Hand-held spirometer
Spirometer in the fifties..
In the lung function lab
Many types are available..
Simplicity
Spirobank
MicroLoop
SpiroPro
SpiroStar
Datospir 70
What do we measure
with a spirometer?
Normal spirogram:
Volume (L)
Volume
/ time
8
Man
176 cm
76 kg
6
FVC
4
FEV1
2
5
10
Time (s)
15
Two important
parameters


FVC - Forced Vital Capacity. This is
the total amount of air that you blow
out in one breath.
FEV1 - Forced Expiratory Volume in
one Second. This is the amount of air
you can blow out within one second.
With normal lungs and airways you
can normally blow out most of the air
from your lungs within one second.
Spirometry: Normal and
COPD
0
FEV1
Normal
COPD
1
Liter
2
FVC
FEV1/ FVC
4.150
5.200
80 %
2.350
3.900
60 %
FEV1
3
COPD
4
FVC
FEV1
Normal
5
1
2
3
FVC
4
5
6 Seconds
Normal spirogram:
Flow/Volume
12
PEF
Flow (L/s)
8
4
0
-4
-8
Volume (L)
Man
176 cm
76 kg
Spirometry and ageing
10
25 yrs 75 yrs
175 cm 171 cm
male
male
Flow (l/s)
8
6
4
2
0
0
1
2
3
Vol (l)
4
5
6
Spirometry allows for



Early detection of airflow obstruction
(often late signs and symptoms)
Better diagnosis (helps to distinguish
between asthma and COPD)
Correct follow-up (compare with blood
pressure meter in hypertension patients)
Reversibility Testing

If airflow obstruction is present, the
test person is given a bronchodilator
(inhalation device)
Reversibility testing
Short acting 2 agonist
Bronchodilators
Flow (L/s )
10
Post
FEV1
FVC
5.25
6.08 16%
PEF
6.49
9.64 49%
6
3.95 51%
2
2
4
Vol ( L )
6

Pre
2.61
+ 12-15 % in FEV1
> 200ml improvement is
considered significant
Reversibility Testing
Airflow obstruction disappears:
REVERSIBLE OBSTRUCTION
(probably asthma)
 Airflow obstruction remains:
IRREVERSIBLE OBSTRUCTION
(probably COPD)

A children’s game?
But needs a maximal effort
Where can I get
spirometry?
 Hospital
services
 Pneumologist
 Many general practitioners

new technique for primary care
 Lung
function lab
Telemedicine?
Know your numbers!
 Blood
pressure
 Cholesterol and glycemia
 FEV1 [= ESW = VEMS]
 and FVC
[= (geforceerde) vitale capaciteit ]
[= capacité vitale (forcée)]
SPIROMETRY
 Is
a safe and simple test
 Provides useful data
 Is underused until now…
Blow to know !