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BASIC PRINCIPLE ON LUNG FUNCTION TEST

Prof.dr.Tamsil Syafiuddin, SpP(K)

Tingkat kemampuan menurut Piramid Miller :Tingkat kemampuan 1:

Mengetahui dan MenjelaskanMelihat atau pernah didemonstrasikan melakukan atau pernah menerapkan di bawah supervisi melakukan secara mandiri

Tingkat kemampuan 2:Pernah

Tingkat kemampuan 3:Pernah

Tingkat kemampuan 4:Mampu

Standar Kompetensi Dokter, Konsil Kedokteran Indonesia, 2006

Diagnostic proceduresLung function tests/spirometry Histamine provocation test Allergy tests Hyperventilation provocation test Perfusion/ventilation scan Bronchoscopy -1- -2- -3- -4-1- -2- -3- -4-1- -2- -3- -4-1- -2- -3- -4-1- -2- -3- -4-1- -2- -3- -4-

Standar Kompetensi Dokter, Konsil Kedokteran Indonesia, 2006

INTRODUCTION The function of lung is for gas exchange Respiration is to allow oxygen to move from the air into the venous blood and carbon dioxide to move out

RESPIRATION Ventilation Diffusion Perfusion

VENTILATIONLung volume Static lung volume Dynamic lung volume Spirometry

SPIROMETRY( To Spir = Bernapas )

SPIROMETRYMeasurement of Lung volume Simple Easy to perform

Reliable

SPIROMETRY Sensitive Accurate Reproducible

SPIROMETRYATS recommendation : 3 acceptable 2 reproducible Maximal 8 maneuver

SPIROMETRY Good preparation Good maneuver

Accurate resultGarbage in garbage out

The new spirometri = Dynamic lung volume

Flow

Obtructive

Obstructive

Volume Restrictive

Restrictive

6 5 4 3 2 1 0 1 2 3 4 5 6

FEV1

FVC

Time (sec)Fig . Normal forced expiration curve

Obstructive

FEV1

Restrictive

FVC

Static Lung Volume

TV IRV ERV RV IC VC FRC

0,5 3,0 1,3 1,2 3,5 4,8 2,5

TLCTab. 1. Static ventilatory parameters in litres.

6,0

RESTRICTION

VC < 80% VC predicted

OBSTRUCTIONFEV1 < 75% FVC FEV1 < 80% FEV1 predicted

PEAK FLOW METER Serial measurement

Restriction / obstruction

LUNG FUNCTION TEST

1. To establish diagnosis

LUNG FUNCTION TEST

2. To evaluate treatment

LUNG FUNCTION TEST

3. To monitor the nature of disease

LUNG FUNCTION TEST

4. To determine the degree of disability

LUNG FUNCTION TEST

5. To determine the prognosis

RESIDUAL VOLUMEI. Helium equilibrium ~ Open circuit method

~ Close circuit methodII. Body plethysmograph

FLOW VOLUME CURVE Maneuver

Additional information

VENTILATION SCANNINGUsing radioactive gas

Xenon Argon

DIFFUSION DLCO Single breath method Rebreathing method

PERFUSION Dye dilusion

Perfusion scanning

CONCLUSION Lung function test give information about the disease Spirometry is a simple method to measure ventilation Good preparation and good maneuver is important Serial measurement is necessary