Spirometry - goals, indications and contraindications, lung status indicators, how the procedure is carried out, norms, decoding the results where to do, price. Spirometry and spirography

The date: 21.10.2019

- Method for determining pulmonary volumes and tanks when performing various respiratory maneuvers (measurement of the designer and its components, as well as freak and FE

Spirography- The method of graphical registration of changes in pulmonary volumes and tanks with calm breathing and performing various respiratory maneuvers. Spirography allows you to evaluate pulmonary volumes and containers, showing bronchial patency, some indicators of pulmonary ventilation (mod, MVL), oxygen intake - P0 2.

In our clinic, the diagnosis of the function of external respiration (spirometry) is performed on a modern software and hardware complex. The diagnostic device, the sensor of which is equipped with a disposable removable mouthpiece, real-time measures the speed and amount of air exhausted. Data from the sensor is entered into the computer and processed by a program that captures the slightest deviations from the norm. Then the doctor of functional diagnostics assesses the initial data and the product of computer analysis of the spirogram, relates them to the data of previously performed research and individual characteristics of the patient. The research results are reflected in the detailed written conclusion.

For more accurate diagnostics used Test with a broncholitic. Respiratory parameters are measured before and after the inhalation of the bronchussessing drug. If initially bronons were narrowed (spasmodic), then with the second dimension, on the background of the effect of inhalation, the volume and speed of exhaled air will increase significantly. The difference between the first and second research is based on the program, is interpreted by the doctor and is described in conclusion.

Preparation for research functions of external respiration (spirometry)

Do not smoke and do not drink coffee in 1 hour before the study.
Easy food intake 2-3 hours before the study.
Cancellation of drugs (according to the recommendation of the doctor): short-acting B2-agonists (Salbutol, Ventoline, Berodal, Berretk, Atrovant) - 4-6 hours before research; B2-agonists of prolonged action (Salmetterol, Formoterol) - in 12 hours; Prolonged theophyllins - in 23 hours; Inhalation corticosteroids (SERETS, SIBICORT, BECLUZON) - 24 hours.
Bring with you an outpatient map.

Indications for the study of external respiratory function (spirometry):

1. Diagnosis of bronchial asthma and chronic obstructive pulmonary disease (COPD). Relying on these FVDs and laboratory studies can confirm or reject the diagnosis.

2. Evaluation of the effectiveness of treatment for changes in the spirogramhelps us to choose exactly the treatment that will have an optimal effect.

FVD. Determines how the amount of air enters and comes out of your lungs, and how well it moves. The test checks how well your lungs work. It can be carried out to test pulmonary diseases, reactions to the treatment or determining how well the lungs work before carrying out a surgical operation.

Conditions and rules for conducting spirometry

The study is desirable to carry out in the morning clock (this is the optimal Vari-ANT), an empty stomach or 1-1.5 hours after a light breakfast.
Before conducting the test, the patient must be in a state of rest in those surgery 15-20 minutes. All factors causing emotional excitation should be eliminated.
It is necessary to take into account the time of day and year, since the daily fluctuations of the shutters are more susceptible to persons suffering from pulmonary diseases compared with healthy. In this regard, repeated studies need to be pro-led at the same time of the day.
The patient should not smoke at least for 1 hour before the study. It is useful to register the exact time of smoking the last cigarette and drug intake, the degree of cooperation of the patient with the operator and some unwanted reactions, for example, cough.
Measure from the surveyed weight and height without shoes.
The patient should thoroughly explain the procedure for conducting research. At the same time, it is necessary to focus on preventing air leakage into the environment by a ruined and applying mac-simulatory and expiratory efforts during the corresponding maneuvers.
The study should be carried out in a patient in a vertical sitting position with a slightly raised head. This is due to the fact that pulmonary volumes are strongly dependent on the position of the body and are significantly reduced in a horizontal position compared to the position sitting or standing. The chair for the surveyed should be comfortable, without wheels.
As the exhalation maneuver is fulfilled before reaching the OOL, unwanted on-clones ahead of the body, as it causes the flow of the trachea and methods of the head of the head, the head flexion is undesirable, because this changes the viscous elastic properties of the trachea.
Since during respiratory maneuvers, the chest should be able to move freely, then close clothes should be unbuttoned.
Dental prostheses, with the exception of very poorly fixed, should not be a dream before the examination, since the lips and cheeks are losing the support, which creates conditions for the air leakage by the ruining. The latter should capture teeth and lips. It is necessary to ensure that there are no cracks in the corners of the mouth.
The patient's nose put on the clamp that is necessary for measurements, performing with calm breathing and maximum ventilation of the lungs to hover the air leakage through the nose. During the maneuver, the fritter exhale (partially) through the nose is difficult, nevertheless it is recommended to use the nasal clamp and during such maneuvers, especially if the time of the forced exhalation is significantly elongated.

It is very important to close interaction and mutual understanding between the nurse, conducting the study, and the patient, because Poor or improper execution of maneuvers will lead to erroneous results and incorrect conclusion.

Spirometry- The most important way to assess the pulmonary function.

Spirography - The method of graphical registration of the volume of the lungs during breathing, one of the main methods for diagnosing respiratory diseases.

Allows you to assess:

functional state of lungs and bronchi (in particular the life capacity of the lungs) -

pendant respiratory tract

detect obstruction (bronchi spasm)

the degree of severity of pathological changes.

Indications for spirometry:

Symptoms: shortness of breath, streaming, orthopneus, cough, wet branch, chest pain;

An objective examination data: impaired breathing, exhalation, cyanosis, thoracic deformation is difficult;

Deviation in laboratory tests: hypoxemia, hypercapnia, polycythemia, changes in pulmonary x-rays.

2. Detection of people with risk of pulmonary diseases:

Smokers;

Persons, work or service of which are associated with the effects of harmful substances.

3. Evaluation of preoperative risk.

4. Evaluation of the forecast of the disease.

5. Assessment of health status before participating in programs requiring excessive physical efforts.

6. Assessment of therapeutic interventions and control over the effectiveness of the treatment of acute and chronic lung diseases.

7. Observation of persons working with harmful agents.

8. Military-medical and medical and labor examination.

Contraindications for spirometry:

1. States requiring emergency care.

2. The presence of acute (contagious) period of infectious diseases.

3. States accompanied by disorientation and inadequacy of the patient's behavior.

4. Changes in the field of ENT organs, maxillofacial region, chest, preventing sample or adequate evaluation.

6. Children of younger.

TOabsolute contraindications The conduct of spirometric studies include:

Moderate or expressed hemoptail unknown etiology;

Installed or suspected pneumonia and tuberculosis;

Recent or posted on the day of the survey pneumothorax;

Recent operational surgical intervention.

Fresh acute myocardial infarction, hypertensive crisis or stroke;

Technique study of the function of external respiratory.

The study should be carried out after the half-hour rest lying in bed or sitting in a chair with armrests in a well-ventilated room at 18-20s.

Before the start of the study, the patient should sit 5-10 minutes.

Age, height and gender should be recorded. Consider the racial affiliation of the studied and make appropriate adjustments if they are required.

The patient should avoid smoking within 24 hours before the study, alcohol consumption, wearing clothing, squeezing chest, abundant food 2-3 hours before the study, the use of short-acting brightness, not less than 4 hours before the test. If the patient cannot be at the state of health, the dose and the latter reception time must be reflected in the study protocol.

Although the most informative part of spirographic research is precisely dynamic (high-speed) characteristics of the respiratory act, this method is used to study the static characteristics of respiration (the total capacity of the lungs and its structure).

The total capacity of the lungs (IEEL) corresponds to the volume of air, which can accommodate the lungs when expanding from a complete saving to the position of the maximum inhalation. There are four volumes and four capacities that make up the structure of the IEL.

Pulmonary volumes:

- reserve volume of inhalation (ROVD) - Maximum air volume that can be inhaled after a calm breath. The norm is 1500-2000ml.

- respiratory volume (up) - the volume of air, inhaled and exhaled with each respiratory cycle. On the chart, it is represented by a curve between the levels of calm exhalation and a calm breath; Norm from 300 to 900ml.

- reserve exhalation (row) - This is the maximum amount of air that can be exhaled after a calm exhalation. The norm is 1500-2000ml.

- residual lung volume (OOL,RV) - This is the volume of gas remaining in the lungs after the maximum exhalation. OOL \u003d FEO-ROYDD. The residual volume is 1000-1500ml.

Pulmonary tanks:

- capacity inhale (EVD) \u003d Up to + ROVD;

- lightweight lung capacityVC.) - This is the maximum amount of air that can be exhaled after the inhabitual breath. Tape \u003d ROVD + up to + ROVD;

- total lung capacity (Hell,TLC) \u003d Jack + oole. Hell is the amount of air located in the lungs after the maximum breath. The rate is 5000-6000ml. (The residual volume cannot be determined using one spirometry; it requires additional measurements of the volume of lungs).

- functional Residual Capacity (Foy) - This is the amount of gas located in the lungs after calm exhalation.

In addition to the listed characteristics, the following indicators also use to estimate the spirometry:

- lone respiratory volume (mod)- This is the amount of air ventilated light in 1 minute. It is calculated as a work up to the CH (respiratory frequency). On average, 5000ml is equal.

- forced Little Life Capacity (Fire, FVC) - The amount of air that can be exhausted with a forced exhale after a deep maximum breath.

- the volume of forced exhalation for 1 second maneuver freak (FEV1, fev1). This is one of the main indicators characterizing the ventilation of the lungs. The FEV1 reflects mainly the rate of exhalation in the initial and middle part of it and does not depend on the speed at the end of the forced exhalation.

- maximum lung ventilation (MVL) - This is the maximum amount of air that can be ventilated by light for 1 minute. Normally equal to 80-200l / min.

- respiratory Reserve (RD) - An indicator characterizing the patient's ability to increase pulmonary ventilation. RD \u003d MVL mod. Norma RD \u003d 85-90% MVL.

- tiffno index (TT) index (TT) - Usually calculated as the ratio of FEV1 / Jack or FEV1 / Ferge, expressed as a percentage. Normally 70-89%.

- MOS 25 (FEF25%) - Instant volume air velocity at the level of exhalation of 25% of the cliff.

- Mos 50. (FEF50%) - Instant bulk air velocity at the exhalation level of 50% of the freak.

- Mos 75. (FEF75%) - Instant surround air velocity at the exhalation level of 75% of freak.

- SOS 25-75 - The bulk speed of the forced exhalation, averaged for a certain period of measurements - from 25% to 75% of theble. The indicator primarily reflects the condition of small respiratory tract, more informative than the FEV1 when identifying early obstructive violations, does not depend on the effort.

- PIC (PEF)- peak (maximum) volumetric exhalation rate when performing Chapel sample.

- MOS50% VD (MIF50%)- The maximum volumetric speed of the inhalation at 50% of the vital container of the lungs.

- MIP (mm.vd.st.)- Maximum inspiratory pressure (achieved with the smallest light volume (RV), when the ratio of the length-voltage in the diaphragm is optimized).

- measures (mm.vd.st.) - the maximum exhalation pressure (patients with neuromuscular diseases are often not able to achieve maximum pressure values, which implies restrictive pathology of lungs).

Analysis and evaluation of spirometric research results

Interpretation or deciphering of the alcohol test data is reduced to the analysis of the absolute values \u200b\u200bof the FEV1, the flange and their relationship (FEV1 / Fer), comparing these data with the expected (normal) indicators and the study of the shape of the graphs. You can consider reliable data obtained from three attempts if they do not differ from each other than 5% (this corresponds to about 100 ml).

On the basis of a spirit, it can be concluded that in a patient of one of two versions of violations of the ventilation function of the lungs: obstructive, the pathogenesis of which is associated with the impairment of respiratory tract, or restrictive (restrictive), which occurs in the presence of obstacles to normal lightweights.

In the obstructive embodiment of the breakability of the bronchi can be due to the combination of spasm smooth muskulature of bronchi (bronchospasm), swelling-inflammatory changes of the bronchial tree (swelling and hypertrophy of the mucous membrane, hyper and discrement, accumulation in the lumen of the bronchi pathological content, inflammatory infiltration of the bronchi wall), expiratory Collapse of small bronchi, lung emphysema, tracheobronchial dyskinesia. Since for non-specific diseases of the lungs (COPD, bronchial asthma, bronchiectase) is characterized by bronchial genesis, then it is most often the obstructive version of the ventilation violations.

As a result of processes that limit the maximum tours of the lungs and reduce the level of maximum inhalation, a restrictive version of ventilation disorders is developing. This is a diffuse pneumosclerosis, atelectasis, cysts and tumors, the presence of a gas or liquid in a pleural cavity, massive pleural blows, deformation or chest refueling (kifoscolyosis, behtereva disease), mortal obesity, no lung (due to operational removal).

The mixed type of light ventilation ability of the lungs is relatively often found.

One of the most important diagnostic methods in pulmonology is the study of the function of external respiration (FVD), which is used as part of the diagnosis of diseases of the bronchopulmonary system. Other names of this method are spirography or spirometry. Diagnostics is based on the definition of the functional state of the respiratory tract. The procedure is completely painless and takes a little time, therefore it is used everywhere. FVD can be carried out both adults and children. According to the results of the survey, it can be concluded that exactly the part of the respiratory system is amazed how much the functional indicators are reduced, how dangerous pathology is.

Study of the function of external respiration - 2 200 rubles.

Investigation of external respiratory function with inhalation test
- 2 600 rubles.

10 - 20 minutes

(Duration of the procedure)

Ambulator

Indications

The presence of typical complaints of breathing disruption, shortness of breath and cough.
Diagnosis and control of COPD treatment, asthma.
Suspicions of lung diseases discovered during other diagnostic procedures.
Changes in laboratory indicators of gas exchange in the blood (increased maintenance of carbon dioxide in the blood, reduced oxygen content).
Survey of the respiratory system in preparing for operations or invasive surveys of the lungs.
Screening surveys of smokers, workers of harmful industries, persons suffering from respiratory allergies.

Contraindications

Broncho-pulmonary bleeding.
Aortic aneurysm.
Any form of tuberculosis.
Stroke, heart attack.
Pneumothorax.
The presence of mental or intellectual disorders (may prevent the doctor's instructions, the study will be non-informative).

What is the meaning of the study?

Any pathology in the tissues and organs of the respiratory system leads to a disruption of breathing. The change in the functional state of the bronchi and the lungs is reflected on the spirogram. The disease may affect the chest, which works as a kind of pump, a pulmonary fabric that is responsible for gas exchange and blood saturation with oxygen, or respiratory tracts for which air should be freely.

With the pathology of spirometry, not only the very fact of a respiratory impairment itself will show, but will also help the doctor to understand which lungs department suffered how fast the disease progresses, and what therapeutic events will help best.

In the survey process, several indicators are measured. Each of them depends on gender, age, growth, body weight, heredity, existence of physical exertion and chronic diseases. Therefore, the interpretation of the results should be made by a doctor who is familiar with the history of the patient's disease. Usually, a patient's study is directed by a pulmonologist, an allergist or therapist.

Spirometry with bronchodiolitic

One of the options for conducting the FVD is a study with an inhalation test. Such a study is similar to ordinary spirometry, but the indicators are measured after inhalation of a special aerosol preparation containing broncholitic. Broncholitik is a drug that expanding bronchi. The study will show whether there is hidden bronchospasm, and will also help you choose suitable bronighting agents suitable for treatment.

As a rule, research takes no more than 20 minutes. The doctor will tell a doctor about what and how to do during the procedure. Spirometry with the bronchodiolitic is also completely harmless and does not cause any uncomfortable sensations.

Methodology

The function of external respiration is a study that is carried out using a special device - spirometer. It allows you to fix the speed, as well as the volume of air that falls into the lungs and comes out of them. A special sensor is built into the instrument, which allows you to convert the received information into digital data format. These calculated indicators are processed by a doctor conducting a study.

The survey is carried out in the sitting position. The patient takes a disposable sprinkler in his mouth, connected to a tube of spirometer, the nose closes the clamp (this is necessary so that all the breath takes place through the mouth, and the spirometer would take into account all air). If necessary, the doctor will tell the algorithm of the procedure in detail to make sure that the patient understood everything correctly.

Then the study begins. You need to perform all the directions of the doctor, breathe in a certain way. Usually tests spend several times and calculate the average value - to minimize the error.

The sample with the bronchodiolitic is carried out to assess the degree of obstruction of the bronchi. So, the test helps to distinguish the COPD from asthma, as well as clarify the stage of development of pathology. As a rule, they first carry out spirometry in the classic version, then with an inhalation test. Therefore, the study takes about two times longer.

Preliminary (not interpreted by the doctor) results are ready almost immediately.

Frequently asked Questions

How to prepare for research?

Smokers will have to abandon the bad habit of at least 4 hours before the study.

General training rules:

Exclude physical exertion.
To eliminate any inhalation (with the exception of inhalations for asthmatics and other cases of compulsory reception of medicines).
The last meal must be 2 hours before the survey.
To refrain from the reception of bronchussessing drugs (if the therapy cannot be canceled, the decision on the need and method of the survey takes the attending physician).
Refuse food, drinks and caffeine drugs.
It must be removed from lipstick.
Before the procedure you need to relax a tie, unzipped the collar - so that nothing bothered free breathing.

The research method that allows you to estimate the function of external respiration, is called spirometry. This technique at the moment received a large distribution in medicine as a valuable way to diagnose ventilation disorders, their character, degree and levels that depend on the nature of the curve obtained in the study (spirogram).

Description of the method

Evaluation of the external respiratory function does not allow for a final diagnosis. However, the conduct of spirometry significantly facilitates the task of diagnosis, the differential diagnosis of various diseases, etc. Spirometry allows:

identify the nature of the ventilation disorders that led to certain symptoms (shortness of breath, cough);
assess the severity of chronic obstructive pulmonary disease (COPD), bronchial asthma;
conduct using certain tests differential diagnostics between bronchial asthma and COPD;
monitor ventilation violations and evaluate their dynamics, treatment efficacy, evaluate the forecast of the disease;
estimate the risk of operational intervention in patients with the presence of ventilation disorders;
reveal the presence of contraindications to certain physical stress in patients with ventilation disorders;
to check the presence of ventilation disorders in patients from the risk group (smokers, professional contact with dust and irritating chemicals, etc.), which are currently complaints (screening).

The survey is carried out after a half-hour recreation (for example, in bed or in a comfortable chair). The room should be well ventigable.

The survey does not require complex training. During the day to spirometry, it is necessary to eliminate smoking, taking alcohol, wearing close clothes. It is impossible to overeat before the study, you should not take food less than a few hours before spirometry. It is advisable to exclude the use of short-acting bronchodiolics for 4-5 hours before the study. If it is impossible, it is necessary to inform the medical personnel responsible for the analysis, the last inhalation time.

The study is evaluated by respiratory volumes. Briefing on how to properly carry out breathing maneuvers is carried out by a medical sister immediately before the study.

Contraindications

The technique does not have clear contraindications, except for the overall difficult state or disorders of consciousness that do not allow to make spirometry. Since it is necessary to make certain, sometimes significant efforts to carry out a forced respiratory maneuver, should not be carried out in the first few weeks after the myocardial infarction and operations in the chest and abdominal cavity, ophthalmic surgical interventions. Delay the definition of the function of external respiration follows with pneumothorax, pulmonary bleeding.

In suspected of the presence of the surveyed tuberculosis, all safety standards must be observed.

Decoding results

According to the results of the study, the computer program automatically creates a graph of a spirogram.

The conclusion of the obtained alcohol may have the following form:

norm;
obstructive violations;
restrictive disorders;
mixed ventilation disorders.

What verdict will make a functional diagnostic doctor depends on the compliance / inconsistency of the indicators obtained during the study, normal values. FVD indicators, their normal range, values \u200b\u200bof indicators in the degrees of ventilation disorders are presented in the table ^

All data are submitted as a percentage of the norm (the exception is the modified Tiffno index, which is the absolute value of the same for all categories of citizens), determined depending on the floor, age, weight and growth. It is most importantly the percentage compliance with regulatory indicators, and not absolutely values.

Despite the fact that in any study, the program automatically calculates each of these indicators, the highest informativeness is carried by the first 3: FEZ, OFV 1 and the modified Tiffno index. Depending on the ratio of these indicators, the type of ventilation disorders is determined.

Fire is the greatest air volume that can be inhaled after the maximum exhalation or exhale after the greatest breath. FEV1 is part of the freak determined by the first second of the respiratory maneuver.

Determination of the type of violations

When decreasing, only the fritter determine restrictive disorders, i.e., violations that limit the maximum mobility of the lungs during breathing. Restrictive ventilation disorders can lead as pulmonary diseases (sclerotic processes in a parenchyma of light different etiologies, atelectases, a gloss of gas or liquid in the pleural cavities, etc.) and the pathology of the chest (Bekhterev's disease, scoliosis), leading to the limitation of its mobility.

With the decrease in the FFV1 below normal quantities and relations of the FEV1 / Fire< 70% определяют обструктивные нарушения - патологические состояния, приводящие к сужению просвета дыхательных путей (бронхиальная астма, ХОБЛ, сдавление бронха опухолью или увеличенным лимфатическим узлом, облитерирующий бронхиолит и др.).

With a joint decrease in Ferge and FEV1, a mixed type of ventilation disorders determine. The Tiffno index may correspond to normal values.

According to the results of spirometry, it is impossible to give an unequivocal conclusion. Deciphering the results should be carried out by a specialist, necessarily correlate them from the clinical picture of the disease.

Pharmacological tests

In some cases, the clinical picture of the disease does not unambiguously determine that the patient: COPD or bronchial asthma. Both of these diseases are characterized by the presence of bronchial obstruction, but the narrowing of bronchials at bronchial asthma is reversible (except for the launched cases in patients who have not received treatment for a long time), and when COPD is reversible only partially. In this principle, a test was founded with a broncholitic for reversibility.

The FVD study is carried out before and after the inhalation of 400 μg of Salbutamola (Salomol, Ventoline). The growth of FEV1 by 12% of the initial values \u200b\u200b(about 200 ml in absolute values) speaks of good reversibility of the narrowing of the lumen of the bronchial tree and testifies in favor of bronchial asthma. The increase is less than 12% more characteristic of COPD.

Smaller distribution received a sample with inhalation glucocorticosteroids (ICCC), appointed as a trial therapy on average by 1.5-2 months. An evaluation of the function of the external respiration is carried out before the appointment of ICCC and after. The increase in FEV1 by 12% compared with the initial indicators indicates the reversibility of the impairment of the bronchi and greater probability in a pain of bronchial asthma.

With a combination of complaints characteristic of bronchial asthma, tests for the detection of bronchial hyperreactivity (provocative tests) are carried out with normal spirometry. During their conduct, the initial values \u200b\u200bof the FEV1 are determined, then inhalation of substances provoking bronchospasm (methaholine, histamine) or a test with physical activity are being carried out. The decrease in FEV1 by 20% of the initial values \u200b\u200bindicates a bronchial asthma.

What is the lungs life tank and how to measure it?

All information on the site is presented for informational purposes. Before applying any recommendations, be sure to advocate your doctor.

©, Medical portal about diseases of the respiratory system PNEUMONIJA.RU

Deciphering the results of the FVD study

Stalls 2.04- 52.44% 7.2 very meaning. Reduced

Fire 1.% 7.7 very meaning. Reduced

OFV1 1..72% 7.8 very meaning. Reduced

Tiffno 86., 94 1.4 norm

Pos 3,92 5.6 moderate decline

MOS25 3, .82 4.5 Easy decline

MOS50 2.95 4.2 Easy decline

MOS75 1.01 2.6 Conditional norm

SOS 2.75 3.0 Conditional norm

Please help me decipher the results, since the doctor did not give explanations about this study.

Evaluation of the function of external respiration (FVD) in medicine

Evaluation of the function of external respiration (FVD) in medicine is a very important tool for obtaining conclusions about the condition of the respiratory system. Evaluate the FVD in various methods, the most common and more accurate of which is spirometry. Currently, spirometry is carried out using modern computer equipment, which increases the accuracy of the data obtained several times.

Spirometry is a method for estimating the function of external respiration (FVD) using the determination of the volumes of inhaled and exhaled air and the speed of air masses during breathing. It is a very informative research method.

For evaluation of the external respiratory function, the following readings exist:

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

Spirometry is a secure procedure. It does not have absolute contraindications, but forced (deep) exhalation, which is used in the evaluation of the FVD, should be carried out with caution:

patients with a developed pneumothorax (presence of air in a pleural cavity) and within 2 weeks after its permission;
in the first 2 weeks after the development of myocardial infarction or surgical interventions;
with severe hemoptia (blood release during cough);
with severe bronchial asthma.

Spirometry is contraindicated to children under 5 years old. If it is necessary to evaluate the FVD, the child under 5 years old is applied by a method called bronchonography (BFG).

A patient for the study of the FVD must be breathed some time into the tube of the device, which is called spirograph. This tube (ruble) is one-time and changing after each patient. If the throat is reusable, then after each patient, it gives up disinfection in order to eliminate the transfer of infection from one person to another.

Spirometric study can be carried out with a calm and forced (deep) breathing. The sample with forced breathing is carried out like this: after a deep breath, the person is offered to exhale the machine to the tube as much as possible.

To obtain reliable data, the study is carried out at least 3 times. After receiving spirometry indicators, a medical worker must check how reliable results. If in three attempts, the FVD parameters are significantly different, this indicates the inencleness of the data. In this case, you need to carry out an additional recording of the alcohol.

All studies are performed with a nose clamp to eliminate nasal respiration. In the absence of the Clamp, the Medic must offer the patient to hold the nose with his fingers.

To obtain reliable survey results, some simple rules must be observed.

Do not smoke within 1 hour before the study.
Do not drink alcohol at least 4 hours before spirometry.
Eliminate heavy physical exertion 30 minutes before the study.
Do not eat 3 hours before research.
Clothing on the patient should be free and do not interfere with deep breathing.
If the patient is removable dentures, then before the study should not be removed. It is necessary to remove prostheses only on the recommendation of the doctor in the event that they interfere with the conduct of spirometry.

The following main indicators exist to evaluate the FVD.

Lightweight lung capacity. This parameter shows that the amount of air that a person can mostly breathe or exhale.
Forced Lung Life Capacity (Fire). This is the maximum amount of air that a person can exhale after the maximum inhale. Fire can decrease with many pathologies, but increases only at one - acromegaly (excess of growth hormone). In this disease, all other pulmonary volumes remain normal. The reasons for the decrease in the flanser can be:
- lung pathology (removal of part of the lung, atelectasis (lung dip), fibrosis, heart failure, etc.);
- pathology of pleura (pleurisy, tumors of pleura, etc.);
- reduction of the sizes of the chest;
- pathology of respiratory muscles.

The volume of forced exhalation in the first second (OFV1) is part of the frequent, which is registered in the first second of the forced exhalation. FEV1 decreases during restrictive and obstructive diseases of the bronchopulmonary system. Restrictive disorders are states that are accompanied by a decrease in the volume of pulmonary fabric. Obstructive violations are states that reduce the permeability of the air paths. To distinguish between these types of disorders, it is necessary to know the values \u200b\u200bof the Tiffno index.
Tiffno Index (FEV1 / Fire). With obstructive violations, this indicator is always reduced, during restrictive or normal, or even increased.

If the patient has an increase or normal values \u200b\u200bof Fan, but the decrease in the FEV1 and the Tiffno index, they are talking about obstructive violations. If the freak and the FFV1 are reduced, and the index Tiffno is normal or elevated, this indicates restrictive disorders. And if all the indicators are reduced (FELL, OFV1, Tiffno Index), then make conclusions about disorders of the FVD on the mixed type.

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

It should be noted that the parameters indicating the pulmonary restriction can deceive the doctor. Often restrictive violations are registered where they are not in fact (false-positive result). For accurate diagnosis of pulmonary restriction, a method is used, which is called bodiletism.

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

When the patient is detected in the patient, the disorders of the FVD on obstructive type must be additionally carried out with the bronchodiolitic to determine the reversibility of obstruction (violation of the armor) of the bronchi.

The bronchitational test is in carrying out the inhalation of the bronchology (substance expanding bronchi) after performing spirometry. Then after a certain time (the exact time depends on the bronchoditics used), the spirometry is carried out again and compare the indicators of the first and second study. The obstruction is reversible if the growth increase in the second study is 12% or more. If this figure is lower, then make a conclusion about the irreversible obstruction. The reversible bronchial obstruction is most often observed in bronchial asthma, irreversible - with chronic obstructive pulmonary disease (COPD).

These tests are used to assess the presence of bronchial hyperreactivity, which takes place at bronchial asthma. To do this, the patient is inhalation of substances that are able to cause bronchial spasms (histamine, methaolin). Now these tests are rarely used due to their potential danger to the patient.

It should be noted that only a competent doctor specialist should be engaged in the interpretation of spirometry results.

Bronchonography (BFG) is used for children up to 5 years. It lies not in recording respiratory volumes, but in recording respiratory noise. The BFG is based on the analysis of respiratory noise in different sounds: low-frequency (200-1200 Hz), mid-frequency (1200 - 5000 Hz), high-frequency (5000-Hz). For each range, the acoustic component of breathing (AKD) is calculated. It is a final characteristic, proportional to the physical work of the lungs spent on the commission of respiratory. ACD is expressed in microdzhoules (ICJ). The most accurate is the high-frequency range, since significant changes in ACD, testifying to the presence of bronchial obstruction, are detected in it. This method is carried out only with calm breathing. Conducting the BFG with deep breathing makes the results of the survey in unreliable. It should be noted that the BFG is a new diagnostic method, so the use of it in the clinic is limited.

Thus, spirometry is an important method of diagnosing diseases of the respiratory system, control over their treatment and determination of the forecast for the patient's life and health.

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

Other methods do not have such widespread use. The reason for this is the fact that their use is still poorly studied.

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Diseases, consultations, diagnosis and treatment

Function of external respiratory: research methods

(FVD) is one of the main directions of the instrumental diagnosis of pulmonic diseases. It includes such methods as:

In a narrower sense, under the study of FVD, the two first methods carried out simultaneously using an electronic apparatus - spirograph.

In our article we will talk about the testimony, prepare for the listed studies, the interpretation of the results obtained. This will help patients with respiratory diseases to navigate the need for one or another diagnostic procedure and it is better to understand the data obtained.

A little about our breath

Breathing -Inted process, as a result of which the organism from the air receives oxygen necessary for life, and highlights carbon dioxide formed during the exchange of substances. Breath has such steps: external (with the participation of the lungs), the transfer of gases by erythrocytes of blood and tissue, that is, the exchange of gases between erythrocytes and tissues.

Gas transfer is examined by pulse oximetry and analysis of blood gas composition. We will talk a little about these methods in our topic.

The study of the ventilation function of the lungs is available and is carried out almost everywhere in respiratory diseases. It is based on measuring the pulmonary volumes and speed of air flow during breathing.

Respiratory volumes and capacity

Lightweight lung capacity - the largest air volume, exhaled after the deepest breath. Almost this volume shows how much air can "fit" into the lungs with deep breathing and participate in gas exchange. With a decrease in this indicator, they are talking about restrictive disorders, that is, a decrease in the breathing surface of the Alveol.

The functional life capacity of the lungs (freak) is measured as well, but only during rapid exhalation. Its value is less yellow due to the falling at the end of the rapid exhalation of the part of the air paths, as a result of which some air volume remains in Alveoli "unseen". If the freak is larger or equal to the jam, the sample is considered as incorrectly made. If the felt is smaller on 1 liter and more, it speaks about the pathology of small bronchi, which fall too early, without giving air to get out of the lungs.

During the execution of a maneuver with a rapid exhalation, another very important parameter is determined - the volume of the forced exhalation in 1 second (OFV1). It decreases with obstructive disorders, that is, in obstacles to the air from the bronchial tree, in particular, in chronic bronchitis and severe bronchial asthma. The FEV1 is compared with due value or use its ratio to jerk (Tiffno Index).

The decrease in the index of Tiffno less than 70% indicates a pronounced bronchial obstruction.

The indicator of minute lung ventilation (MVL) is determined - the amount of air transmitted to the lungs with the lowest and deep breath per minute. Normally, it ranges from 150 liters and more.

Research Function Function

It is used to determine the pulmonary volumes and speeds. Functional samples are often prescribed, registering changes in these indicators after the action of any factor.

Indications and contraindications

The FVD study is carried out with any diseases of the bronchi and lungs, accompanied by a violation of bronchial passability and / or a decrease in the respiratory surface:

The study is contraindicated in the following cases:

children under 4 - 5 years old who cannot correctly execute nurse commands;
acute infectious diseases and fever;
heavy angina, acute period of myocardial infarction;
high arterial pressure numbers, recently transferred stroke;
stagnant heart failure, accompanied by shortness of breath at rest and with a slight load;
mental disorders that do not allow proper instructions.

How the study is carried out

The procedure is carried out in the office of functional diagnostics, in the sitting position, preferably in the morning on an empty stomach or no earlier than 1.5 hours after meals. For the purpose of the doctor, bronchological drugs can be canceled, which constantly accepts the patient: Beta2-agonists of a short action - in 6 hours, beta-2 agonists of an extended action - for 12 hours, long-term theophyllines - per day before survey.

Research Function Function

The nose is closed by a patient with a special clamp so that breathing is carried out only through the mouth, using a disposable or sterilizable mouthpiece (throat). The surveyed breathes for some time calmly, not focusing on the respiratory process.

Then the patient is offered to make a calm maximum breath and the same calm maximum exhale. So the desires are estimated. To evaluate the freak and the FEV1, the patient makes a calm deep breath and the entire air exhales as soon as possible. These indicators are recorded three times with a small interval.

At the end of the study, a rather tedious registration of MVL is carried out when the patient is breathing as deeply and fast for 10 seconds. At this time, a little dizziness may occur. It is not dangerous and quickly passes after stopping the sample.

Many patients are prescribed functional samples. The most common of them:

sample with salbutomol;
sample with exercise.

Less often a test with methawin.

When conducting a sample with salbutol after registering the initial spirogram, the patient is proposed to make the inhalation of Salbutamola - beta2 of a short action agonist, expanding spasmated bronchi. After 15 minutes, the study repeat. You can also use the inhalation of m-cholinolics of the bromide and bromide, in this case, the study is re-conducted after 30 minutes. Introduction can be carried out not only with the help of a dosage aerosol inhaler, but in some cases using a spacer or nebulizer.

The sample is considered positive with an increase in the indicator of the FEV1 by 12% and more while simultaneously increasing its absolute value per 200 ml and more. This means that the revealed original bronchial obstruction that manifested itself with a decrease in the FEV1 is reversible, and after the inhalation of Salbutamol, the permeability of the bronchi improves. This is observed with bronchial asthma.

If, with the initially reduced indicator of the FEV1, the test is negative, this indicates the irreversible bronchial obstruction when the bronchi does not react to the extensive drugs. This situation is observed in chronic bronchitis and uncharacter for asthma.

If after the inhalation of Salbutamol, the indicator of FEV1 decreased, this is a paradoxical reaction associated with the bronchi spasm in response to inhalation.

Finally, if the sample is positive against the background of the original normal value of the FEV1, this indicates the hyperreactivity of the bronchi or the hidden bronchial obstruction.

When conducting a test with a load, the patient performs an exercise on a cyergometer or a treadmill 6 - 8 minutes, after which they are re-examined. With a decrease in the FEV1 by 10% and more talk about a positive sample, which indicates an asthma of physical effort.

For diagnosis of bronchial asthma, a provocative test with histamine or methawin is also used in pulmonary hospitals. These substances cause spasm changed bronchi in a sick person. After the inhalation of methaolin, repeated measurements are carried out. The decrease in FEV1 by 20% and more indicates the hyperreactivity of the bronchi and the possibility of bronchial asthma.

As interpreted results

Basically, in practice, the doctor of functional diagnostics is focused on 2 indicators - jelly and FEV1. Most often they are estimated by the table proposed by R. F. Clement and co-authors. We give a common table for men and women in which interest is given from the norm:

For example, with an indicator of 55% and FEV1 90%, the doctor will conclude a significant decrease in the life capacity of the lungs with normal bronchial patency. This condition is characteristic of restrictive violations at pneumonia, Alveolitis. In the chronic obstructive disease of the lungs, on the contrary, it can be, for example, 70% (light decrease), and the OFV1 - 47% (reduced sharply), while the sample with salbutola is negative.

On interpretation of samples with bronchodilies, we have already talked to the load and methawin higher.

Another way to estimate the function of external respiration is also used. In this method, the doctor is focused on 2 indicators - forced lung life capacity (FVC) and FEV1. Fire is determined after a deep breath with a sharp exhale that continues as long as possible. In a healthy person, both of these indicators make up more than 80% of normal.

If the freak is more than 80% of the norm, the FEV1 is less than 80% of the norm, and their ratio (the Genezlar index, not the index Tiffno!) Less than 70%, talk about obstructive violations. They are connected mainly to impaired bronchial patency and exhalation process.

If both indicators are less than 80% of the norm, and their ratio of more than 70%, is a sign of restrictive disorders - lesions of the lung tissue that prevents complete breath.

If the values \u200b\u200bof freak and FEV1 are less than 80% of the norm, and their ratio is less than 70%, these are combined disorders.

To evaluate the reversibility of obstruction, they look at the Q1 / Ferge after the inhalation of Salbutamola. If it remains less than 70% - the obstruction is irreversible. This is a sign of chronic obstructive pulmonary disease. For asthma, the reversible bronchial obstruction is characteristic.

If irreversible obstruction has been revealed, it is necessary to evaluate its severity. For this, the OFV1 is evaluated after the inhalation of Salbutamola. With its magnitude, more than 80% of the norm speak about light obstruction, 50-79% - moderate, 30-49% - pronounced, less than 30% of the norm - sharply pronounced.

The study of the function of external respiration is especially important for determining the severity of bronchial asthma before the start of treatment. In the future, for self-control, patients with asthma must be picofloometer twice a day.

Picoflorometry

This is a research method that helps determine the degree of narrowing (obstruction) of the respiratory tract. Picfloumometry is performed using a small apparatus - picoflorometer equipped with a scale and mouthpiece for exhaled air. The greatest application of picofloumometry received to control the strength of bronchial asthma.

How picfloumometry is held

Each patient with asthma should be picfeloumeter twice a day and record the results in the diary, as well as determine the average values \u200b\u200bper week. In addition, he must know his best result. A decrease in average indicators indicates a deterioration in the monitoring of the disease and the beginning of exacerbation. At the same time, it is necessary to consult a doctor or increase the intensity of therapy, if the pulmonologist explained in advance how to do it.

Chart of daily picfloummetry

Picofloumemetry shows the maximum speed achieved during the exhalation, which is well correlated with the degree of bronchial obstruction. It is held in the sitting position. At first, the patient is calmly breathing, then produces a deep breath, takes the mouthpiece of the device on the lips, keeps the picoflorometer parallel to the floor surface and exhales as quickly and intensively.

The process is repeated after 2 minutes, then once again after 2 minutes. The diary records the best of three indicators. Measurements are made after awakening and before going to bed, at the same time. During the selection period or with a deterioration of the state, an additional measurement can be carried out in the daytime.

How to interpret the data

Normal indicators for this method are determined individually for each patient. At the beginning of regular use, subject to the remission of the disease, there is a better indicator of the peak feed rate (PSV) in 3 weeks. For example, it is 400 l / s. Multipling this number by 0.8, we obtain the minimum boundary of normal values \u200b\u200bfor a given patient - 320 l / min. All that more than this number belongs to the "green zone" and speaks good control over Asthma.

Now I multiply 400 l / s by 0.5 and we get 200 l / s. This is the upper border of the "red zone" - a dangerous reduction in bronchial patency, when urgent help is needed. PSV values \u200b\u200bbetween 200 l / s and 320 l / s are within the "yellow zone" when therapy correction is necessary.

These values \u200b\u200bare convenient to draw on the graph of self-control. So it will be well clear how much asthma is controlled. This will allow you to refer to the doctor with a deterioration in the state, and with long-term good control, it will gradually reduce the dosage of the drugs obtained (also on the purpose of the pulmonologist).

Pulse oximetry

Pulse oximetry helps determine how much oxygen is transferred to the hemoglobin in arterial blood. In the norm, hemoglobin captures up to 4 molecules of this gas, while the saturation of arterial blood oxygen (saturation) is 100%. With a decrease in the amount of oxygen in the blood, saturation decreases.

To determine this indicator, small devices are applied - pulse oximeters. They look like a kind of "clothespin", which is put on the finger. There are portable devices of this type on sale, they can be purchased by any patient, suffering from chronic pulmonary diseases, to control their condition. Pulse oximeters are widely used and doctors.

When pulse oximetry is carried out in the hospital:

during oxygen therapy to control its effectiveness;
in the departments of intensive therapy in respiratory failure;
after severe operational interventions;
with suspected obstructive sleep apnea syndrome - a periodic stop of breathing in a dream.

When you can use a pulse oximeter yourself:

when aggravating asthma or other pulmonary disease, to assess the severity of its condition;
if you suspect the night apnea - if the patient snores, it has obesity, diabetes, hypertensive disease or reduction of the function of the thyroid gland - hypothyroidism.

The saturation rate of arterial blood oxygen is 95 - 98%. With a decrease in this indicator, measured at home, it is necessary to consult a doctor.

Blood gas composition study

This study is carried out in the laboratory, the patient's arterial blood is studied. It defines the content of oxygen, carbon dioxide, saturation, concentration of some other ions. The study is carried out in severe respiratory failure, oxygen therapy and other urgent states, mainly in hospitals, primarily in the departments of intensive therapy.

Blood is taken from radiation, shoulder or femoral artery, then the place of puncture is attached to a cotton ball for a few minutes, the gouring bandage is superimposed when puncture of a large artery to avoid bleeding. Observe the condition of the patient after puncture, it is especially important to notice edema in time, changing the color of the limb; The patient must inform the medical staff if he has numbness, tingling or other unpleasant feelings in the limb.

Normal blood gases:

Reduction of PO 2, O 2 ST, SAO 2, that is, oxygen content, in combination with an increase in the partial pressure of carbon dioxide can talk about such states:

weakness of the respiratory muscles;
oppression of the respiratory center for diseases of the brain and poisoning;
blockage of respiratory tract;
bronchial asthma;
lung emphysema;
pneumonia;
lonantic bleeding.

Reducing the same indicators, but with normal carbon dioxide content happens with such states:

The decrease in the indicator of 2 TE under normal oxygen pressure and saturation is characteristic of pronounced anemia and reducing the volume of circulating blood.

Thus, we see that the conduct of this study, and the interpretation of the results is quite complex. Analysis of the gas composition of blood is necessary to make a decision on serious therapeutic manipulations, in particular, artificial ventilation of the lungs. Therefore, it does not make sense to make it in outpatient conditions.

About how the study of the function of external respiration is carried out, look at the video.

Patients with diseases of the respiratory system are often prescribed a study of the function of external respiration (FVD). Despite the fact that this type of diagnosis is quite simple, affordable, and therefore the common, few know that it represents and for what purpose is carried out.

What is FVD, and for what to measure it

Breathing is a vital process for a person of any age. During the respiratory process, the body is saturated with oxygen and highlights carbon dioxide formed during the metabolism. Therefore, the violation of the respiratory function is able to entail a number of health problems.

External breathing is a medical term, which includes a description of air circulation processes through the respiratory system, its distribution, gas transfer from inhaled air to blood and back.

The study of the FVD, in turn, allows you to calculate the volume of the lungs, to estimate the speed of their work, identify violations of functions, diagnose diseases of the respiratory system and determine effective methods of treatment. Therefore, doctors use FVD for various purposes:

For diagnosis. In this case, the health status is estimated, the effect of the disease on the functionality of the lungs and its forecast. Also, the risk of developing pathology (in smokers, people working in harmful conditions, etc.) is determined.
For dynamic observation of the development of the disease and evaluating the effectiveness of therapy.
To make an expert opinion, which is required when evaluating suitability for work in special conditions and determining temporary disability.

Also, the diagnosis of the function of external respiration is carried out within epidemiological studies and in order to implement a comparative analysis of people's health in different conditions of life.

Indications and restrictions for diagnostics

The reason for the study of the functions of the lungs and the evaluation of FVD is many diseases of the respiratory system. Conducting such diagnostics are prescribed at:

chronic bronchitis;
asthma;
infectious inflammatory process in the lungs;
chronic obstructive pulmonary disease;
silicosis (occupational disease arising from regular inhalation of dust with a high content of silicon dioxide);
idiopathic fibrosing alveolitis and other pathologies.

FVD contraindications include:

age less than 4 years - in case the child is not able to correctly understand and perform the instructions of the health worker;
development in the body of acute infections and feverish states;
heavy angina and myocardial infarction;
stable increase in blood pressure;
stroke transferred shortly before the alleged study;
stagnant heart failure, which is accompanied by respiratory disorders, even at low load and at rest.

Important. Also, this type of diagnosis is not carried out in patients suffering from deviations in mental or mental activity, which do not allow them to adequately react to the requests of the medical staff.

Spirometry

Currently, there are various methods for studying the function of external respiration. One of the most common spirometry is.

For studies of this kind, dry or water spirometer is used - a device consisting of two components. The spirometer sensor registers the amount of inhaled air and the speed with which the surveyed inhales and exhales it. And the microprocessor processes information.

Spirometry allows you to evaluate:

functionality of organs involved in respiration (including the life capacity of the lungs);
respiratory tract;
the complexity of changes in the respiratory system, their type.

In addition, it is detected by bronchial spasms and determine whether changes in the respiratory system are reversible.

Survey process

In the process of diagnostic research, the patient is offered to breathe as deeply as possible, and then exhale in spirometer. Initially, the measurements are carried out in a calm state, and then with forced breathing. The process is repeated several times with small interruptions. When evaluating the result, the greatest indicator is taken into account.

To determine the reversibility of the projection process of bronchi, spirometry is performed with a bronchodiolitic - a drug expanding this respiratory body.

Preparation for research

All research is carried out, as a rule, in the morning on an empty stomach, or two hours after a small breakfast.

In order for the readings of spirometry to be the most accurate, the patient should prepare for it in advance. As part of the training, doctors recommend:

per day to abandon smoking;
do not drink strong tea, coffee and alcoholic beverages;
for half an hour before the examination, exclude active physical activity.

In some cases, the reception of drugs that affect the operation of respiratory organs is also canceled.

During diagnostics on the patient there should be loose clothing that does not interfere with breathing with full breasts.

Decoding results

The average rate of breathing indicators of a healthy person is:

volume (up to) - from 0.5 to 0.8 liters;
frequency (CHD) - 10-20 times / min;
minute volume (mod) - 6-8 liters;
reserve exhalation volume (rowd) - 1-1.5 l;
lightweight lung capacity - from 3 to 5 liters;
forced jam (freak) - 79-80%;
the amount of forced output for the 1st sec. (FEV1) - from 70% Fan.

In addition to these indicators, the instantaneous volumetric rate of exhalation is determined (Mos). It can be traced with a different% filling of the lungs.

Important! The volume and respiratory rate indicators depend on the floor of the patient, its age, weight and physical condition (training). A small variability is allowed in each individual category of the examined (no more than 15% of the norm).

Significant deviations from normal testimony allow the doctor to determine which pathologies take place in the patient's respiratory system. So, if the grinding indicator is 55% of the norm, and the OFV1 is 90%, then this indicates the development of restrictive disorders characteristic of pneumonia, Alveolitis.

Evidence of chronic obstructive pulmonary disease, in turn, consider a slight decrease in the jerks (up to 70%) against the background of a sharp decrease in OVF1 (up to 47%). There are characteristic indicators for other disorders of the functions of respiratory organs.

Bodiletismography

In terms of its functionality, this test is similar to spirometry, however, gives deployed and complete information about the state of the human respiratory system.

Bodipoteticism helps to estimate not only the permeability of the bronchi, but also the volume of the lungs, as well as recognize air traps, which indicate the emphysema of the lungs.

Such diagnostics is carried out with the help of a bodiletimograph - a device consisting of a body chamber (which is followed by the surveyed) with a pneumotafograph and computer. On the latter monitor, research data is displayed.

Picoflorometry

The diagnostic method allowing to determine the speed of inhalation / exhalation, and thereby evaluate the degree of burning respiratory tract.

Of particular importance is a study for those who suffer from bronchial asthma, as well as patients with obstructive pulmonary disease in the chronic stage - it makes it possible to analyze the effectiveness of the selected therapy.

Diagnosis is carried out using a special instrument - picofloumetra. The first in history, a similar device was quite large and heavy, which significantly complicated research. Modern picflumometers are mechanical (in the form of a tube on which divisions with color markers are applied) and electronic (computer), which are distinguished by ease of use and compactness. At the same time, the method of conducting and evaluating the results is so simple that it can be carried out at home.

But, despite this, use the device only on the recommendation of the attending doctor, and even better under its control (you can configure the picoflorometer together with the doctor, and then use it yourself, writing testimony). This approach will allow correct measurements and interpret the indicators.

With picfloumetra:

changes are determined by the changes in the bronchi at different times of the day;
the necessary treatment is planned, the correctness and effectiveness of previous appointments is estimated;
the periods of exacerbation of an asthmatic disease are predicted.

In addition, factors are revealed that increase the risk of aggravation development (in cases where attacks often happen in some places and do not occur at all - in others).

How the research is carried out and the results are evaluated

Before starting regular measurements, the picoflorometer is configured taking into account normal values \u200b\u200bof the peak power of the exhalation (PSV), which depends on the floor, the age group and the growth of the patient. When setting, also, according to special tables, the boundaries of the regions (normal, alarming and unsatisfactory) are calculated.

For example, the PSV norm of middle-aged men and growth (175 cm) is 627 l / min. The normal area (on the device it is marked in green) at the same time it is at least 80% of the norm, that is, 501.6 l / min.

In anxious (yellow), there are indicators from 50 to 80% (in the case under consideration from 313.5 to 501.6 l / min).

All values \u200b\u200bbelow the disturbing region will be noted in unsatisfactory (red).

Important. As an option for tuning the picofloumometer, the patient spirometry indicators can be used (the best research rate is taken as the basis).

Terms of Use

For the maximum full picture, picoflorometry is performed twice a day - in the morning and in the evening. Special preparation for diagnostics is not required, but there are a number of rules that require strict compliance:

diagnosis is carried out before receiving medicines;
before starting the study, the pointer runner is set to the beginning of the scale;
during measurements, the patient stands or sits (the back at the same time);
the device is kept in a horizontal position with both hands (hands do not close the slider and holes);
first, breathe deeply inhale and briefly delay their breath, after which they make a strong exhalation as quickly as possible.

Important. Each measurement is performed three times, with short breaks. The maximum indicator of the device is fixed and is noted in an individual graph, with which the doctor will later get acquainted.

Additional research

In addition to the main methods of research, to clarify the diagnosis or evaluation of the effectiveness of treatment, the doctor is often used by additional tests.

So, with spirometry, samples are prescribed from:

salbutomol;
exercise;
metaholin.

Salbutol - a preparation with a bronchology effect. The functional test with it is carried out after the control studies and allows you to establish whether the narrowings in bronchus are reversible or not. It also gives a more accurate picture of the condition of the respiratory system and makes it possible to clarify the diagnosis. So, if after receiving the bronchology, the indicator of the FEV1 is improving, this indicates asthma. If the sample gives a negative result - it says about chronic bronchitis.

Metacholine is a substance provoking spasm (hence and the name of the sample is a provocative test) and allowing with 100% accuracy to determine the disease asthma.

As for samples with a load, in this case the second study is carried out after exercises on a bicycle or running simulator and allows you to determine the ASTMU of physical effort with maximum accuracy.

Diffusion test is also often used as an additional study. It allows you to estimate the speed and quality of blood oxygen supply.

The reduced indicators in this case indicate the development of the lungs (and in the already defined form), or on the possible thromboembolism of the artery in the lungs.