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    Spirometry Interpretation: Lung Volumes

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    Bobet Reña
    Spirometry measures lung volumes and capacities through forced expiratory maneuvers. Key values include FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and the FEV1/FVC ratio. An obstructive pattern is identified by a reduced FEV1 and FEV1/FVC ratio, indicating obstruction of airflow from conditions like asthma and COPD. A restrictive pattern shows reduced FVC and normal or increased FEV1/FVC, suggesting decreased lung volume from issues involving the lung parenchyma or chest wall. Spirometry requires at least 3 acceptable tests to validate results and determine the pattern of ventilatory impairment.

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    Spirometry Interpretation: Lung Volumes

    Uploaded by

    Bobet Reña
    170 views4 pages
    Spirometry measures lung volumes and capacities through forced expiratory maneuvers. Key values include FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and the FEV1/FVC ratio. An obstructive pattern is identified by a reduced FEV1 and FEV1/FVC ratio, indicating obstruction of airflow from conditions like asthma and COPD. A restrictive pattern shows reduced FVC and normal or increased FEV1/FVC, suggesting decreased lung volume from issues involving the lung parenchyma or chest wall. Spirometry requires at least 3 acceptable tests to validate results and determine the pattern of ventilatory impairment.

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    Spirometry Interpretation

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    Spirometry Interpretation

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    Spirometry measures lung volumes and capacities through forced expiratory maneuvers. Key values include FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and the FEV1/FVC ratio. An obstructive pattern is identified by a reduced FEV1 and FEV1/FVC ratio, indicating obstruction of airflow from conditions like asthma and COPD. A restrictive pattern shows reduced FVC and normal or increased FEV1/FVC, suggesting decreased lung volume from issues involving the lung parenchyma or chest wall. Spirometry requires at least 3 acceptable tests to validate results and determine the pattern of ventilatory impairment.

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    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    170 views4 pages

    Spirometry Interpretation: Lung Volumes

    Uploaded by

    Bobet Reña
    Spirometry measures lung volumes and capacities through forced expiratory maneuvers. Key values include FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and the FEV1/FVC ratio. An obstructive pattern is identified by a reduced FEV1 and FEV1/FVC ratio, indicating obstruction of airflow from conditions like asthma and COPD. A restrictive pattern shows reduced FVC and normal or increased FEV1/FVC, suggesting decreased lung volume from issues involving the lung parenchyma or chest wall. Spirometry requires at least 3 acceptable tests to validate results and determine the pattern of ventilatory impairment.

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    SPIROMETRY INTERPRETATION

    Lung volumes
    ERVExpiratory reserve volume; the maximal volume of air exhaled from end-expiration.
    IRVInspiratory reserve volume; the maximal volume of air inhaled from end-inspiration.
    RVResidual volume; the volume of air remaining in the lungs after a maximal exhalation.
    VT Tidal volume; the volume of air inhaled or exhaled during each respiratory cycle.

    Lung capacities
    FRCFunctional residual capacity; the volume of air in the lungs at resting end-expiration.
    ICInspiratory capacity; the maximal volume of air that can be inhaled from the resting expiratory level.
    TLCTotal lung capacity; the volume of air in the lungs at maximal inflation.
    VCVital capacity; the largest volume measured on complete exhalation after full inspiration.
    FVCForced vital capacity; the total volume of air that can be exhaled during a maximal forced expiration effort.

    Spirometric values
    FEV1Forced expiratory volume in one second; the volume of air exhaled in the first second under force after a
    maximal inhalation.
    FEV1/ FVC ratioThe percentage of the FVC expired in one second.

    In obstructive pattern, there is scooping


    of the loop. A restrictive pattern
    produces a mini-version of the
    normal.

    Scooping

    (A) Restrictive ventilatory defect. (B) Normal spirogram. (C) Obstructive ventilatory defect.

    OBSTRUCTIVE PATTERN
    Decreased FEV1
    Decreased FVC
    Decreased FEV1/FVC (<70% predicted)
    FEV1 used to follow severity in COPD
    Asthma
    COPD
    - chronic bronchitis
    - emphysema
    Bronchiectasis
    Bronchiolitis
    Upper airway obstruction

    RESTRICTIVE PATTERN
    Decreased FEV1
    Decreased FVC
    FEV1/FVC normal or increased
    Pleural
    Parenchymal
    Chest wall
    Neuromuscular

    Bronchodilator Response

    Degree to which FEV1 improves with inhaled bronchodilator

    Documents reversible airflow obstruction

    Significant response if:


    o FEV1 increases by 12% and >200ml

    Request if obstructive pattern on spirometry

    To determine the validity of spirometric results, at least three acceptable spirograms must be obtained. In each test, patients
    should exhale for at least six seconds and stop when there is no volume change for one second. The test session is finished when the
    difference between the two largest FVC measurements and between the two largest FEV1 measurements is within 0.2 L. If both criteria
    are not met after three maneuvers, the test should not be interpreted. Repeat testing should continue until the criteria are met or until
    eight tests have been performed.

    If the test is valid, the second step is to determine whether an obstructive or restrictive ventilatory pattern is
    present.
    o When the FVC and FEV1 are decreased, the distinction between an obstructive and restrictive ventilatory pattern
    depends on the absolute FEV1/FVC ratio.
    o If the absolute FEV1/FVC ratio is normal or increased, a RESTRICTIVE ventilatory impairment may be present.
    However, to make a definitive diagnosis of restrictive lung disease, the patient should be referred to a
    pulmonary laboratory for static lung volumes. If the TLC is less than 80 percent, the pattern is restrictive, and
    diseases such as pleural effusion, pneumonia, pulmonary fibrosis, and congestive heart failure should be
    considered.
    o A reduced FEV1 and absolute FEV1/FVC ratio indicates an OBSTRUCTIVE ventilatory pattern, and
    bronchodilator challenge testing is recommended to detect patients with reversible airway obstruction (e.g.,
    asthma).
    A bronchodilator is given, and spirometry is repeated after several minutes. The test is POSITIVE if the
    FEV1 increases by at least 12 percent and the FVC increases by at least 200 mL. The patient should not

    use any bronchodilator for at least 48 hours before the test. A negative bronchodilator response does not
    completely exclude the diagnosis of asthma.

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