Understanding the structure and subtleties of the respiratory system is vital to human anatomy. To detect abnormalities in the respiratory system, an HPF test is also performed, also known as a diagnosis of the function of external respiration.

What is HPF?

To identify a disease, such as asthma, the doctor must review the symptoms and medical history, family history, and conduct a pulmonary function test.

  HFD tests are non-invasive tests that show how well the lungs work.

Tests measure lung volume, capacity, flow rates and gas exchange. This information can help your doctor diagnose and make further decisions about the treatment of certain lung diseases. Each person may require a different type of test, and doctors may prescribe one or more lung function tests, depending on the underlying problem.

There are several types of test:

1. spirometry: measures the amount of air consumed.
2. plethysmography: measures the volume of gas in the lungs, known as the volume of the lungs.
3. diffusion test: assesses how well small air sacs inside the lungs called alveoli work.

There are various reasons why external respiration may be evaluated. Sometimes it is carried out as part of normal therapy in healthy people. But, usually, the procedure is performed in certain areas of professional activity to ensure the health of employees (such as graphite plants and coal mines). Or in the event that the doctor needs help to diagnose health problems, such as:

• allergy;
• respiratory infections;
• breathing problems due to a chest injury or recent surgery;
• chronic disease: asthma, bronchiectasis, emphysema or chronic bronchitis;
• asbestosis - a disease of the lungs caused by inhalation of asbestos fibers;
• restrictive airway problems due to scoliosis, swelling, inflammation, or scarring of the lungs;
• sarcoidosis is a disease that causes clusters of inflammatory cells around organs such as the liver, lungs, and spleen;
• scleroderma is a disease that causes thickening and hardening of connective tissue.

These studies can be used to check lung function before surgery or other procedures in patients with lung or heart disease, smokers, or other pathologies. Another use of research is to evaluate the treatment of asthma, emphysema and other chronic lung problems.

What does the HPF show?

HFD tests may include tests that measure lung size and airflow, such as spirometry and lung volume tests. Other tests measure how well gases, such as oxygen, enter and exit the blood. These tests include pulse oximetry and arterial blood gas readings.

  Sometimes an extended study of the function of external respiration is required, including analysis of all indicators.

Another lung function test, called fractionally expired nitric oxide (FeNO), measures nitric oxide, which is a marker of pneumonia. A patient may have one or more of these tests to diagnose, compare lung function with expected levels of function, monitor the stability of the disease or worsen its condition, and verify treatment effectiveness. The purpose, procedure, discomfort and risks of each test will vary.

The main parameters in the research of FVD:

• tidal volume (VT) - the amount of air consumed during normal breathing;
• minute volume (MV) - the total amount of exhaled air per minute;
• total capacity - the volume of air that can be exhaled after inhalation, as far as possible;
• functional residual capacity (FRC) - the amount of air remaining in the lungs after normal exhalation;
• total lung volume when filled with as much air as possible;
• forced capacity (FVC) - the amount of air exhaled by force and quickly after inhalation, as far as possible;
• the amount of air expired during the first, second and third seconds of the test;
• forced expiration (FEF) - average flow rate during the middle half of the test;
• peak expiratory flow rate (PEFR) is the highest rate at which air can be exhaled from the lungs.

Normal test values \u200b\u200bvary from person to person. The results are also compared with any of your previous test results.

FVD and spirometry: what is the difference?

During spirometry, the patient will sit with the mouthpiece in front of the equipment. It is important that the mouthpiece fits snugly, and all the consumed air enters the apparatus.

Spirometry measures the amount of inhaled air: it measures only the speed of the air flow and estimates the size of the lungs.

Also, the procedure involves the use of a nose clip so as not to inhale air through it. The doctor will ask you to inhale and exhale as deep as possible, or breathe faster for several seconds. Also, the doctor may ask you to inhale a medicine that opens the airways. Then you will need to again inhale into the external respiration apparatus to see if the medicine affects the lungs.

In medicine, HPF studies determine a general and detailed analysis of the quality of lung function.

For example, lung volume tests are the most accurate way to measure how much air the lungs can hold. This test measures the volume of gas in the lungs, known as the volume of the lungs.

The diffusion capacity of the lungs determines how well oxygen enters the bloodstream of the inhaled air. Pulse oximetry measures the level of oxygen in the blood. Tests for the fractionally exhaled nitric oxide content measure its amount in exhaled air. Other tests may be needed to evaluate lung function in infants, children, or patients who are unable to perform spirometry and lung volume tests.

How is the function of external respiration performed?

The test is performed on an outpatient basis. The method of performing the procedure may vary. It depends on the patient's condition and treatment methods.

  The patient needs to describe in detail his symptoms (cough, shortness of breath, shortness of breath, chest tightness), including when and how often they occur.

In most cases, the procedure will be carried out as follows:

• the patient sitting in a chair will be asked to take off tight clothing, jewelry, or other things that may cause breathing problems;
• then a soft clip will be put on the nose so that breathing is carried out directly through the mouth, and a sterile mouthpiece attached to the spirometer will be given;
• a person will need to close his mouth tightly with a mouthpiece;
• during the procedure, the doctor will carefully monitor the patient’s dizziness, breathing problems and other negative manifestations.

After certain tests, a person may be given a bronchodilator. Then the tests will be repeated a few minutes after it takes effect.

How to breathe on FVD?

For the reliability of the study of HPF, a number of regulatory conditions must be observed. Before the procedure, you must take a horizontal position for 15 minutes. Tests include various studies, rarely limited to one, since only comprehensive testing allows you to fully analyze the position of the lungs.

  The process of necessary breathing during testing depends on its type.

During spirometry, the volume of the lungs is measured, for which the patient takes a natural breath in the equipment.

During pneumotachography, the rate of air intake through the respiratory tract in the natural state is analyzed, and the result of the HPF with load is investigated. When analyzing the vital capacity of the lungs, an intensively deep breath is taken. Reserve capacity will be the difference between this indicator and lung capacity.

Preparation for the examination of the HPF

The patient will be asked to sign a consent form that gives permission for the HF procedure. The patient will need to tell the doctor that he is taking any medications, including OTC drugs, vitamins, and herbal supplements.

  You should be prepared to adjust your asthma medication intake: some may affect your test results.

Also need:

• stop taking certain medications before the procedure, if prescribed by a doctor;
• do not eat “heavy” food before the test;
• no smoking;
• follow any other instructions given by the doctor.

Before taking a methacholine test, you need to tell your doctor if you have recently had a viral infection, such as a cold. And also about recent vaccinations or immunizations, as this may affect the test results.

Where can I pass the analysis of the HPF?

Nowadays, many clinics provide FVD studies. It is important that the clinic is equipped with advanced diagnostic equipment necessary for a high-quality investigation of the high-pressure function. It is also necessary that truly experienced diagnosticians and pulmonologists work in the clinic. Ensuring compliance with the analysis and providing accurate results is important.

In the capital, a test can be done in one of the proven centers - Yusupov Hospital or in the CELT clinic.

FVD procedure cost

The cost of a general study varies from region to region and averages 3,000 rubles. Usually the first appointment, including examination and consultation of a pulmonologist, costs an average of 1500-1800 rubles. Repeated - cheaper. Analysis of provoked tidal volumes on average costs 1,600 rubles. Analysis of tidal volumes using various drugs - about 800 rubles.

FVD norms in adults: a transcript

Average values \u200b\u200bvary for each person. Doctors will review the test results and compare them with typical average values \u200b\u200bfor people of the same height, age, and gender to calculate a condition index.

There is a statement that the human lungs grow up to 20 years, then their function begins to decline slowly. Take into account growth, gender and other factors. Taller people and men tend to have larger lungs.

  Doctors may sometimes perform additional tests to confirm their findings before proceeding with the diagnosis.

Values \u200b\u200bthat are abnormal compared to other measurements may be a sign of lung problems. Individual results vary, so deciphering the results is done personally.

Positive Ventolin test: what does it mean?

The Ventolin test is a quick, simple, and painless method for assessing respiratory function. It takes about 60 minutes and is done for:

• identifying and confirming asthma, and monitoring the course of the disease.
• to distinguish asthma from COPD.

  Ventolin is a medicine that is distributed in the respiratory system.

As a result of this test, an improvement is considered normal if the FEV1 value is increased by ≥200 ml and ≥12% of the norm (or the initial value). In the current protocols for the treatment of asthma and COPD, the result of Ventolin tests is not predictive, with a long-term response to anti-inflammatory treatment, and because of the progression of these diseases.

Based on practicality, the cardinal result of the test is normal FEV1 / FVC after treatment, excluding the diagnosis of COPD. Obstruction after the drug can be with both COPD and asthma. In patients, the value of the Ventolin sample may vary over time. Having received the result of the sample, you need to analyze the data, making a conclusion about a possible pathology.

A healthy patient should have good basic spirogram parameters: the volume of forced vital capacity, phase conjugation and lung ventilation of at least 80% of the average values. If the indicators decreased to 70%, then this is accepted as a pathology.

Sometimes it is necessary to study the function of the lungs after inhalation of drugs that are distributed in the respiratory system, for example, HPF with Metacholine. It can also be a spirometric study using drugs, such as a bronchodilator test, for example, FVD with Salbutamol. If the test with Salbutomol has a dubious result, use a bronchodilation test with Formoterol.

Assessment of the function of external respiration (HFD) in medicine is a very important tool for obtaining conclusions about the state of the respiratory system. EFD can be estimated using various methods, the most common and more accurate of which is spirometry. At present, spirometry is performed using modern computer technology, which increases the reliability of the data obtained several times.

Show all

  Spirometry

Spirometry is a method for evaluating the function of external respiration (HF) by determining the volume of inhaled and exhaled air and the speed of movement of air masses during breathing. It is a very informative research method.

Spirometry should be performed only on the recommendation of a competent medical specialist.

  Indications

To assess the function of external respiration, the following indications exist:

• diagnosis of diseases of the respiratory system (bronchial asthma, chronic obstructive pulmonary disease, chronic bronchitis, alveolitis, etc.);
• assessment of the effect of any disease on the function of the lungs and airways;
• screening (mass examination) of people who have risk factors for the development of pulmonary pathology (smoking, interaction with harmful substances, due to the profession, hereditary predisposition);
• preoperative risk assessment of breathing problems during surgery;
• analysis of the effectiveness of the treatment of pulmonary pathology;
• assessment of pulmonary function in determining disability.



Spirometry is an important method for the diagnosis of respiratory diseases

  Contraindications

Spirometry is a safe procedure.   It does not have absolute contraindications, but the forced (deep) exhalation, which is used when evaluating the HPF, should be performed with caution:

• patients with developed pneumothorax (the presence of air in the pleural cavity) and within 2 weeks after its resolution;
• in the first 2 weeks after the development of myocardial infarction or surgical interventions;
• with severe hemoptysis (blood secretion when coughing);
• with severe bronchial asthma.

Spirometry is contraindicated in children under 5 years of age. If it is necessary to evaluate VFD in a child under 5 years of age, a method called bronchophonography (BFG) is used.



  Research Methodology

To study the HPF, a patient needs to breathe into the tube of a device called a spirograph for some time. This tube (mouthpiece) is disposable and changes after each patient. If the mouthpiece is reusable, then after each patient it is given for disinfection in order to exclude the transmission of infection from one person to another.

Spirometric examination can be carried out with calm and forced (deep) breathing. A test with forced breathing is carried out as follows: after a deep breath, a person is offered to exhale as much as possible into the tube of the device.

To obtain reliable data, the study is conducted at least 3 times. After receiving spirometry indicators, the medical professional must check how reliable the results are. If in three attempts the parameters of the HPF are significantly different, then this indicates the reliability of the data. In this case, an additional spirogram recording is required.

All studies are performed with a nasal clamp to exclude nasal breathing. In the absence of a clamp, the physician should offer the patient to pinch his nose with his fingers.

  Study preparation

To obtain reliable examination results, you must follow some simple rules.

• Do not smoke for 1 hour before testing.
• Do not drink alcohol at least 4 hours before spirometry.
• Eliminate heavy physical activity 30 minutes before the study.
• Do not eat 3 hours before the study.
• Clothing on the patient should be loose and not interfere with deep breathing.
• If the patient wears removable dentures, then before the study, do not remove them. Removing prostheses is necessary only on the recommendation of a doctor if they interfere with spirometry.

  Spirometry

The following main indicators exist for evaluating the HPF.

• Vital lung capacity (VC). This parameter shows the amount of air that a person is able to inhale or exhale as much as possible.
• Forced lung capacity (FVC). This is the maximum amount of air that a person is able to exhale after a maximum breath. FVC can decrease with many pathologies, and increases only with one - acromegaly (excess growth hormone). With this disease, all other pulmonary volumes remain normal. The reasons for the decrease in FVC can be:
  • lung pathology (removal of a part of the lung, atelectasis (lung collapse), fibrosis, heart failure, etc.);
  • pleural pathology (pleurisy, pleural tumors, etc.);
  • reduction of the size of the chest;
  • pathology of the respiratory muscles.
• The volume of forced expiration in the first second (FEV1) is part of the FVC, which is recorded in the first second of forced expiration. FEV1 decreases with restrictive and obstructive diseases of the bronchopulmonary system. Restrictive disorders are conditions that are accompanied by a decrease in the volume of lung tissue. Obstructive disorders are conditions that reduce airway patency. To distinguish between these types of violations, you need to know the values \u200b\u200bof the Tiffno index.
• Tiffno Index (FEV1 / FVC). In obstructive disorders, this indicator is always reduced, in case of restrictive disorders it is either normal or even increased.



  Deciphering the results

If the patient has an increase or normal values \u200b\u200bof FVC, but a decrease in FEV1 and the Tiffno index, then talk about obstructive disorders. If FVC and FEV1 are reduced, and the Tiffno index is normal or increased, then this indicates restrictive disorders. And if all indicators are reduced (FVC, FEV1, Tiffno index), then they make conclusions about mixed-type FVD violations.

Options for conclusions on the results of spirometry are presented in the table.

Violation Option	FZHEL	FEV1	tiffno index
Obstructive disorders	norm/	↓	↓
Restrictive Disorders	↓	↓	norm/
Mixed violations	↓	↓	↓

It should be noted that parameters indicating pulmonary restriction can deceive the doctor. Often, restrictive disorders are recorded where they are not in reality (false-positive result). For an accurate diagnosis of pulmonary restriction, a method called bodyplethysmography is used.

The degree of obstructive disorders is determined by the values \u200b\u200bof the FEV1 indicators and the Tiffno index. The algorithm for determining the degree of bronchial obstruction is presented in the table.

  Bronchodilation test

If a patient reveals violations of the FVD by obstructive type, it is necessary to additionally conduct a test with a bronchodilator to determine the reversibility of obstruction (patency impairment) of the bronchi.

The bronchodilation test consists in inhaling a bronchodilator (a substance that dilates the bronchi) after performing spirometry. Then after a certain time (the exact time depends on the bronchodilator used), spirometry is performed again and the indices of the first and second studies are compared. Obstruction is reversible if the increase in FEV1 in the second study is 12% or more. If this indicator is lower, then a conclusion is made about irreversible obstruction. Reversible bronchial obstruction is most often observed in bronchial asthma, irreversible in chronic obstructive pulmonary disease (COPD).

Bronchophonography (BFG) is used for children under 5 years old. It consists not in recording tidal volumes, but in recording respiratory sounds. BFG is based on the analysis of respiratory noise in different sound ranges: low-frequency (200 - 1200 Hz), mid-frequency (1200 - 5000 Hz), high-frequency (5000 - 12600 Hz). For each range, the acoustic respiration component (AKRD) is calculated. It represents the final characteristic proportional to the physical work of the lungs spent on the act of breathing. AKRE is expressed in microjoules (μJ). The most indicative is the high-frequency range, since significant changes in AKRD, indicating the presence of bronchial obstruction, are detected in it. This method is carried out only with calm breathing. Conducting BFG with deep breathing makes the results of the examination unreliable. It should be noted that BFG is a new diagnostic method, therefore its use in the clinic is limited.

  Conclusion

Thus, spirometry is an important method for diagnosing diseases of the respiratory system, monitoring their treatment and determining the prognosis for the life and health of the patient.

In some cases, after the implementation of this method, additional procedures should be carried out. Therefore, the doctor may prescribe, for example, the passage of bronchodilation testing.

Other methods do not have such widespread use. The reason for this is that their application is still poorly understood in practice.

The breath of a person is an important component that provides a person with not just normal life, but life itself. As a result, doctors pay a lot of attention to normal breathing, which leads to the need for regular examination. This is even more important when there are problems with the respiratory organs.

In this case, FVD is always prescribed - a special examination of the function of external respiration. To determine the deviations, a test with Salbutamol, a bronchodilator of the group of selective β2-adrenoreceptor agonists, is used. The results of the examination before taking Salbutamol and after are carefully studied, on the basis of which it is possible to identify various diseases of the respiratory system.

FVD examination is the main direction of instrumental diagnostics in identifying pulmonological diseases. The examination method includes such examination methods as:

Breathing is a vital process necessary for a person, allowing the body to receive the amount of oxygen that the cells need for normal life. With a lack of oxygen, cells begin to break down, leading to disruptions in the functioning of internal organs. This often occurs due to bronchospasm. The reason for it and allows you to determine the examination of the HPF.

In most cases, spirometry is used to determine deviations from the norm in breathing, which allows:

The presented examination is carried out at the time of physical activity or before and after inhalation with bronchodilator drugs. The benefits of FVD using Salbutamol will be discussed later.

Indications and contraindications for examination

The doctor begins to speak about the conduct of the HPF when he sees the patient as a potential danger of developing a pulmonary disease - often the patient himself complains about breathing problems. For the examination, the following indications are distinguished:

Additionally, an examination of the HPF is carried out in the following cases:

• before employment, where harmful working conditions are noted;
• before surgery with the need for intubation anesthesia;
• during screening for changes.

We must not forget about contraindications for the conduct of high pressure function, which include:

FVD examination is not conducted for young children and the elderly over 75 years.

Training

Now we should talk in more detail about the preparation, conduct and results of the pulmonological examination under consideration.

The doctor tells more about the preparation, guided by the individuality of the case and the patient himself - it is important to determine the exact prohibitions in a particular suspicion or disease. The main features include the following points:

It is important to consider and comply with all the restrictions and features in preparation, then the resulting indicators will be as reliable as possible. Otherwise, provided that any pathology is revealed by the results, the HPF must be repeated.

FVD

After preparation, they begin the examination itself. In this case, the patient sits in a chair in a straight pose, with his hands on the armrests. A specialist prepares a spirometer device that measures the indicators necessary for diagnosis - puts on a disposable mouthpiece. Then the patient puts on a nose clip on the nose, and the specialist requires you to do the following:

The presented actions are done several times, after which the results are studied by a specialist, and a verdict is issued.

About performance standards

To determine the pathology and other disorders in the pulmonary system, the main indicators are used. On their basis, other components are also determined by appropriate calculations. In the results obtained, the patient often meets more than 20 values, each of which determines one or another respiratory factor. Now, only the basic values \u200b\u200bshould be given, in case of deviation of which the doctor concludes the developing violations.

The above indicators are only basic, allowing to determine the presence of problems with the respiratory system. To deal with the nature of the problem is possible only after studying and comparing all the meanings and individual factors.

It should only be noted that the reliability of the results is determined in the absence of errors between the indicators of three repetitions.   The error is allowed, but not more than in a 5% ratio, and this is only 100 ml. In other cases, you will have to take the test again.

Sample with Salbutamol

A test with the use of Salbutamol is carried out when revealing an obstructive type of respiratory failure - the presence of bronchospasm. Salbutamol is a special bronchodilator drug that makes it possible to determine the degree of reversibility of changes and the severity of diseases.

The survey is conducted twice. First, the patient exhales into the device before applying Salbutamol. After fixing the indicators, the patient is allowed to take 2-3 breaths with an inhaler, into which the drug was previously poured for testing. After 15-30 minutes, the HPF procedure is repeated again, the indicators of which are also recorded. Next, the doctor determines a positive test or not.

A positive test is diagnosed when determining the increased value of the forced expiratory volume in 1 second (FEV1) by 12%, which in a quantitative value is 200 ml. The FEV1 indicator may be more, but it means that the revealed obstruction is reversible and after taking in the form of an inhalation with Salbutamol, bronchial patency improves significantly - this makes it possible to restore the respiratory system.

If the test with Salbutamol is negative, then this means that the bronchial obstruction is not reversible, and the bronchi do not react in any way to the use of a bronchodilator in the treatment.

This is important: before examining FVD with Salbutamol for 6 hours, other bronchodilator drugs are prohibited.

Spirometry or spirography with salbutamol

Spirometry is a standard test of lung function and volume, which helps to identify possible causes of gas exchange. Spirography is a graphical examination of lung volume and expiratory air velocity by recording indicators over time.

But neither spirometry nor spirography gives an accurate and more reliable result. Often hidden bronchospasms remain undetected when using standard examination techniques.

Another thing is the use of bronchodilator Salbutamol. In the case of spirometry, the drug allows you to determine hidden disorders in breathing. Spirometry with the use of Salbutamol gives a more accurate picture of the functionality of breathing and even reveals latent bronchospasm.

Such an application is necessary when the patient complains of characteristic difficulty breathing, but standard examination methods did not reveal deviations.

Patient Maria, 54 years old.   Has a full physique, consulted a doctor with breathing problems - a convulsive breath is periodically formed. Due to such difficulties in breathing, headaches and an increase in blood pressure appeared. A routine spirometry examination did not reveal breathing problems.

However, after applying Salbutamol, doctors revealed latent bronchospasm. The reason was established after - diaphragm displacement due to an increased amount of fat on the internal organs of the abdominal cavity. Recommended diet for weight loss and taking bronchodilator drugs.

If you have breathing problems, do not postpone a visit to the doctor. In the shortest possible time, an examination of the HPF will be carried out, which will determine the cause of the impaired functionality of the respiratory system and prescribe the appropriate treatment.

Preparation for functional diagnostics

Memo for the patient in preparation for spirography

(study of the function of external respiration)

In preparation for the study, you must follow simple rules:

- if you smoke, do not smoke during the day before the test (if this did not work out, strictly do not smoke for 2 hours before the test);

- do not drink alcohol during the day before the study;

- to exclude a plentiful meal 2 hours before the study, your breakfast should be light;

- exclude physical activity (including physical education and climbing stairs) during2 hours before the study;

- put on clothes that do not constrain movement before research, come to research in advance, relax in front of the office;

- Be sure to inform the specialist conducting the study about your taking medications (name, dose, last time on the day of the study). Be careful, this information is very important!

- you need to know the exact data of height and weight;

- carry a handkerchief;

  Before the study, the following medications are strictly prohibited:

• in 6 hours - salbutamol, ventolin, berotek, salamol, astmopent, berodual, terbutaline (brikanil), alupent, atrovent, traventol, truvent, or their analogues;
• in 12 hours - theopec, theodur, theotard, monophylline retard;
• in 24 hours - intal, cromolyn sodium, ditec, servent, formoterol, volmax;
• in 96 hours - hormonal preparations - becotide, ingacort, budesonide forte, flexotide.
• During the study of the function of external respiration, you will breathe in an individual mouthpiece, the device will measure the speed and volume of air flow during inhalation and exhalation. Perhaps some samples will be repeated several times to select a result. During the study, to assess the reaction of your body, it may be necessary to take or inhale the drug and then repeat the study.
• The study is safe, usually takes 15-30 minutes, if you correctly perform the respiratory movements recommended by the specialist conducting the study. You can discuss the results of the study with your doctor.

Before the study on the EEG is necessary:
  - wash your hair on the eve of the study
- do not use styling products on the day of the study
  - feed infants before the study.

Before conducting an EEG video test, the patient must comply with the following conditions:
  The study is carried out only by appointment.
  To have with you:
  - direction or medical history,
  - a diaper or sheet.
  Young children, a bottle with a mixture of tea, juice, water, as well as toys, books.
  Preparation for the study:
  The time of night sleep on the eve of the study and the time of waking up on the day of the study are discussed in advance with the doctor who conducts video monitoring of the EEG. For the study, the child must be delivered awake,
  because during the study it is very important to record how the child falls asleep. The clothing should be comfortable, soft with long sleeves
  long pants (you can’t hide during the study). If the study is carried out at lunch time, it is advisable to feed the child before the study.

Before conducting an ABPM study, the patient must comply with the following conditions:

Wearable recorder SMAD is set for a day. Blood pressure measurements are taken automatically in the daytime every 15 minutes,
  at night, every 30 minutes. ineffective measurement of blood pressure or upon receipt of a measurement result that differs sharply from the previous measurement, the device
  measures blood pressure after 3 minutes. If repeated measurements are often repeated, check the position of the cuff on the arm.

When conducting a study:

  - any change of activity, especially physical activity (any, even insignificant, namely: running, walking, climbing - descending the stairs);



  - any complaints about a change in well-being.
  Keeping such a diary allows the doctor to clarify the causes of episodic elevations or lowering blood pressure and correctly interpret the results of the study.
  3. The patient needs to control the position of the cuff and, if necessary, correct it so that the lower edge is 1 to 2 fingers higher than the elbow. Perform all cuff manipulations after successful measurement of blood pressure. 4. During the study is prohibited:





  - other diagnostic procedures (X-ray, ultrasound scan, gamma-ray scintigraphy, computed and magnetic resonance imaging)

- remove the batteries from the monitor; - mechanically damage or wet the device (do not take a shower or bath on the day of the study). 5. The patient (child) learns about the beginning of the measurement by squeezing the shoulder due to the increase in pressure in the cuff. At this moment, if the patient was walking or running, it is necessary to stop, lower the arm with the cuff along the trunk, to relax the muscles of the arm as much as possible, not to move your fingers and not to talk. If the patient was sitting or lying, it is necessary to leave the hand in the same position in which it was at the time the device was turned on and not move. 6. In case of excessive clamping of the hand and the occurrence of unpleasant disturbances in it (swelling, discoloration), it is necessary after measurement:
  - raise your arm with the cuff up to restore blood circulation;
  - Contact the medical staff or the department where the device was installed.

Before conducting a study of SCM ECG, the patient must comply with the following conditions:

Wearable CXM ECG recorder is installed for a day, constantly recording ECG
  throughout the duration of the study.

When conducting a study:
  1. The daily routine, the regime of physical activity should be as ordinary as possible.
  2. The patient must keep a self-observation diary, which must be noted in time:
  - any change of activity, especially physical activity (any, even insignificant, namely: running, walking, climbing - descending the stairs);
  - psycho - emotional stress;
  - main meals and medications (indicating the name and dose of the drug);
  - sleep (time to fall asleep and time to wake up);
  - any complaints about a change in well-being, especially painful or unpleasant sensations in the heart, interruptions in the heart rhythm.
  Keeping such a diary allows the doctor to correctly interpret the results of the study.
  3. During the study, it is prohibited:
  - be near and use microwave ovens;
  - use cordless phones and cell phones;
  - pass through the metal detector arch and electromagnetic arches in stores;
  - use electric vehicles (trams, trolleybuses, electric trains);
  - work with a computer (including with a laptop);
  - conducting other diagnostic procedures (x-ray, ultrasound scan, gamma scintigraphy, computed and magnetic resonance imaging)
  - independently disconnect the connectors of the device;
  - remove the batteries from the monitor;
- mechanically damage or wet the device (do not take a shower or bath on the day of the study);
  - Do not touch the wires and electrodes unnecessarily. In the event that there is a disconnection of the wires from the electrodes or electrodes from the body, it is necessary to restore the integrity of the system, because ECG recording may stop or may be unreadable.

Memo for the patient in preparation for endoscopic examination of the intestine

(fibrocolonoscopy, sigmoidoscopy)

Intestinal preparation is one of the most important factors for successful endoscopic examination, the result of which is an accurate diagnosis.

For quality bowel preparation, 2 conditions must be met:

2-3-day strict adherence to a non-slag diet, on the day of preparation for the study: switching to clear liquids and products equivalent to them (clear broth, green tea, clear juices without pulp, jelly without berries and grains, still water)

Direct bowel cleansing with FORTRANS, “FLIT-Phospho-soda” preparations (following the instructions for use)

If during the use of drugs, while cleansing the intestines, pain in the stomach appeared cramping in nature - call an ambulance!

Three days before the study:

You can not: Meat, brown bread, fresh fruits and vegetables, herbs, beans and peas, mushrooms, berries, seeds, nuts, jam with pits, including small (currant and raspberry), grapes, kiwi.

Do not take petroleum jelly, activated charcoal and preparations containing iron!

You can: Broth, boiled meat, fish, chicken, cheese, white bread, butter, cookies (without poppy seeds)

If you suffer from constipation, you need to take a laxative at least a week before the study (consult your doctor about the drug).

Remember! If the endoscopist is not satisfied with the preparation of your intestines, the study will be rescheduled.

Do not hesitate to ask, the doctor and the nurse will give you detailed, understandable recommendations on how to behave during the procedure so that it goes the least unpleasantly, in the shortest possible time and successfully. Listen carefully and follow the advice of the doctor conducting the study.

Place of research: GAUZ NSO "GKP No. 1", Lermontov St., 38, room number 117

Take a sheet and a towel with you.

Preparation for laboratory tests

Blood analysis: A prerequisite is fasting blood sampling. For 1-2 days, exclude fatty, fried foods from the diet. Blood should not be donated after radiography, massage, physiotherapy. The results of studies are affected by the use of medications. If you are taking medications, you should definitely warn the doctor about this.

Blood glucoseIN ADDITION TO ALL THIS LISTED, IT IS IMPOSSIBLE: TO CLEAN YOUR TEETH, CHEAD A CHEWING RUBBER, DRINK TEA OR COFFEE (NOT EVEN SWEET). ANY ACCEPTED TABLET AGENTS MAY BE AFFECTED BY THIS ANALYSIS.

General urine analysis: BEFORE HOW TO COLLECT THE URINE IN THE FIRST-WALLED DISHES, IT IS NECESSARY TO CARRY OUT THE TOILET OF EXTERNAL GENITAL ORGANS AND DRY THEM WITH A CLEAN TOWEL. DO NOT USE A DIRTY CLEANER IS REDUCED. AND AFTER RECEPTION OF ALCOHOL IN 24 HOURS. GATHER THE FIRST MORNING PORTION (THE PREVIOUS URINE SHOULD NOT BE BEEN LATER THAN 4-6 HOURS). 50-100 ML OF URINE IS ENOUGH FOR ANALYSIS.

Urinalysis according to Nechiporenko.: Before collecting urine, conduct hygiene of the external genital organs, as well as before a general urinalysis, after which an average portion of early urine is collected in a clean container with a volume of 100 ml.

3.Analysis is given on an empty stomach, while cardiovascular and antihypertensive drugs are not canceled !!!

4. On the day the sugar curve analysis is taken, the patient arrives at room 15 at 8 o’clock in the morning with a referral from the attending physician with the result of a blood test for glucose and 75 g of glucose in powder (redeem at the pharmacy the day before). Carry an individual glass for glucose dissolution.

5. The glucose solution is prepared by the laboratory assistant.

6. The patient takes blood on an empty stomach, then give a solution of glucose (no more than 5-10 minutes).

7. After 2 hours after exercise, the blood is taken again.

Glucose natoschak and after 2 hours after eating:

When assigning a fasting glucose test and 2 hours after eating, the testee gives blood on an empty stomach from 8 to 10 in the morning, and the next day gives blood 2 hours after eating (porridge or butter roll and a glass of tea) from 8 to 10 in the morning.

Memo for the patient in preparation for a biochemical examination of urine (calcium, phosphorus, Reberg test, uric acid)

• Urine collection begins at 7 a.m., while the night portion is poured into the toilet, and the remaining portions during the day (from 7 a.m. to 7 a.m. the next day) are collected in clean dishes with a capacity of 1.5 - 2 liters.
• Urine is stored at a temperature of +4 C to +8 C.
• Before delivery to the laboratory, the urine is thoroughly mixed and the volume is measured with an accuracy of 10 ml. (Infants with an accuracy of 1 ml.), cast 50 - 100 ml. for delivery to the laboratory.
• Urine is delivered to the laboratory at ul. Lermontov No. 40, 2nd floor, inter-district centralized biochemical laboratory, in the accompanying form, the patient indicates the time of collection and the total volume of urine.
  

Preparation for abdominal MRI:

• . during the day, it is necessary to abandon food products that increase gas formation (carbonated drinks, sour-milk products, brown bread, fruits, vegetables);
• .when conducting an MRI of the spleen, liver, pancreas, a carbohydrate-free diet is sometimes recommended 2-3 days before the procedure;
• .on the day of the diagnosis, it is advisable to eat light food, refuse coffee and tea;
• .after the last meal, at least 6-8 hours should pass;
• . should refrain from drinking 4-6 hours before the examination;
• . with increased gas formation, it is recommended to take a tablet of Espumisan or activated carbon;
• . You must have with you all the necessary medical documentation regarding the organ under investigation (ultrasound, CT, x-ray, postoperative extracts).
• Memo for the patient in preparation for x-ray examination of the urinary tract, lumbar spine, irrigoscopy
• 1. 2 days before the study, exclude from the diet foods that cause bloating (legumes, fresh fruits, vegetables, black bread, milk)
• 2. On the eve of the study, take 30 g in the morning. (2 tbsp) castor oil.
• 3. On the day of the study, 3 hours before the study, make a cleansing enema.
• 4. For irrigoscopy, bring a sheet and toilet paper.

Preparation before an ultrasound scan.

Ultrasound of the abdominal cavity:

2-3 days before the examination, it is recommended to switch to a non-slag diet, to exclude from the diet products that enhance gas formation in the intestines (raw vegetables rich in fiber, whole milk, black bread, legumes, carbonated drinks, as well as high-calorie confectionery products - cakes, cakes ) The last meal in 2000 the day before, children up to a year three hours before a meal.

It is advisable to take enzyme preparations and enterosorbents (for example, festal, mesim forte, activated carbon or espumisan 1 tablet 3 times a day) during this period of time, which will help reduce flatulence.

Ultrasound of the abdominal organs should be performed on an empty stomach. If you do not plan to conduct the study in the morning, a light breakfast is allowed at least 6 hours before the study.

Gynecological ultrasound:

The transabdominal (through the abdomen) test is performed with a full bladder, so you need not to urinate before the test for 3-4 hours and drink 1 liter of still water 1 hour before the procedure.

For transvaginal ultrasound, special preparation is not required, this study is used, inter alia, to determine early pregnancy.

Ultrasound of the bladder and prostate in men:

The study is carried out with a full bladder, so you need not to urinate before the study for 1-2 hours and drink 1 liter of non-carbonated liquid 1 hour before the procedure. Before transrectal examination of the prostate (TRUS), a cleansing enema is necessary.

Ultrasound of the mammary glands:

The study of the mammary glands is preferably carried out from 5 to 10 days of the menstrual cycle (optimally 5-7 days). The first day of the cycle is considered from the beginning of menstruation.

All existing in the world studies of the function of external respiration can be done with us at IntegraMedservice promptly and professionally.

• If you need an assessment or examination of FVD - spirography, bodyplethysmography, assessment of diffusion capacity of the lungs, feel free to contact us
• If you need spirography for a planned operation, we will quickly do it and give a detailed conclusion.
• Need spirometry at home? Nothing is easier! We conduct spirometry at home, both as a separate study, and as part of a pulmonologist's consultation at home
• We do spirography for children
• if necessary, we can immediately give.

Spirometric study

Spirography is an informative, non-invasive, painless study of pulmonary function. Using this method, it is possible to determine whether there are changes in the speed of air passage through the bronchi, the nature of this disorder, how air passes through the bronchi and the forced vital capacity of the lungs.

Why is spirometry and spirography necessary?

1. allows you to accurately diagnose bronchial obstructive pulmonary diseases:, with bronchial obstruction, bronchiolitis.
2. suspect restrictive pulmonary disease.
3. Spirometry is often necessary for anesthetists, before elective surgery under general anesthesia.
4. Spirometry is performed for both children and adult patients. It is carried out for children provided that the child fulfills the teams of the doctor conducting the study.

How is spirometry performed?

When performing spirometry in our medical center

• a pulmonologist will ask you to make three attempts to maximize inhalation and exhalation into a special device (spirograph), through a disposable mouthpiece tube.
• all the results obtained are stored and processed by the device.
• having received the result, the doctor immediately gives a written opinion.
• especially for children, we use, when carrying out the FVD, an animation program built into the computer. It’s easier and more fun for a child to go through a boring, but necessary, visit to a doctor.

Spirometry with a bronchodilator drug (bronchodilator)

This is the conduct of the above spirometry after inhalation, by a specific maneuver, of a bronchodilator drug (ventolin, salbutamol, berodual). By all rules, it must be carried out necessarily, since you can skip the hidden bronchospasm. In addition, the test allows you to determine whether bronchodilators can help you, and which ones.

The total duration of complete spirometry with a bronchodilator takes 20 minutes.

Bronchial provocation test with methacholine

This is an inhalation study of methadoline by high-pressure filters. This type of spirometry allows you to identify hyperreactivity, readiness for bronchospasm in patients with a controversial diagnosis of bronchial asthma, a “cough” variant of bronchial asthma and physical effort asthma. In other words, allows any bronchial asthma to be detected. Under these conditions, normal spirometry is normal, a test with a bronchodilator is negative. And only an expert test with methacholine can correctly diagnose if there is asthma or not.

The rules of preparation for the study of FVD: spirometry, bodyplethysmography

Breathing tests are not recommended for:
   pain in the heart, angina pectoris
   after surgery on the eyes, chest, or abdomen
   recently transferred pneumothorax
   with individual sensitivity to drugs

A few tips:

• do not take bronchodilators (discuss the period of non-use with your pulmonologist)
• don’t over-eat - a full stomach will interfere with doing the right maneuvers
• do not smoke or exercise, at least 6-8 hours before the study

Want to do spirography of the function of external respiration?
   Why do we have to make HPF better?
   Where do you do: spirometry, bodyplethysmography, a test with methacholine?

• integraMedservice Medical Center is licensed for functional diagnostics and pulmonology
• in the pulmonology department of our medical center we will carry out all the necessary breathing tests, at the highest professional level
• we have pulmonologists and specialists working to study the function of external respiration only from the Research Institute of Pulmonology
• we know how to work with children
• we can do spirometry at home
• you immediately get the result, and if you want, then the consultation of a pulmonologist
• conclusions of our experts are respected in medical circles