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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