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Pulmonary Function Tests

Pulmonary Function Tests. O ther tests of lung function:1. Lung mechanics -Resistance -Compliance 2. Distribution of Ventilation (N2 delta)

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Pulmonary Function Tests

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  1. Pulmonary Function Tests Other tests of lung function:1. Lung mechanics-Resistance -Compliance 2. Distribution of Ventilation (N2 delta) 3. Maximal Respiratory Pressures (MIP, MEP)

  2. V/Q ratio

  3. V/Q mismatch (3-compartment model)

  4. Lung volumes and capacities

  5. How to measure FRC (RV,TLC) ? • Nitrogen washout method • Inert gas dilution technique • Plethysmography

  6. Resistance

  7. Volume dependence of airway resistance (Raw) 4 3 SRaw (cmH2O/L/sec) 2 1 0 2 4 6 8 Lung Volume (liters) RV TLC

  8. Compliance

  9. Compliance

  10. Ventilatory Mechanics: Healthy 100 % VC Pcw 80 PRS 60 40 PL 20 0 20 40 60 -60 -40 -20 0 Pressure (cmH2O)

  11. 4 3 2 SRaw (cmH2O/L/sec) 1 0 2 4 6 8 Lung Volume (liters) Ventilatory Mechanics: Healthy ΔPΔV 100 ΔP ΔV % VC RV 80  elastic WOB 60 elastic and resistive work of breathing is minimized when tidal breathing occurs within the compliant portion of the respiratory systems P-V curve TLC 40 ΔPΔV 20  resistive WOB 0 20 40 60 -60 -40 -20 0 Pressure (cmH2O) SRaw as lung volume  because the airways distend as the lungs inflate, and bigger airways have lower resistance (*Poiseuilles’ Law*). The opposite is also true, of course!

  12. Ventilatory Mechanics: Healthy Begin Exercise IC IC VT

  13. 8  EILV 6 Volume (liters) 4  EELV 2 0 -40 -30 -20 -10 0 10 20 30 40 50 Pressure (cmH20) Ventilatory Mechanics: Healthy TLC  IRV  IC  VT EELV RV

  14. Dynamic hyperinflation during exercise IRV IRV

  15. Diffusion capacity (DLCO, DLCO/VA, Tco, Kco)

  16. Mechanism of hypoxaemia

  17. Hypoxaemia, hypercapnia in clinical cases

  18. Respiratory and metabolic shifts chronic acute acute chronic

  19. Exercise tests in lung diseases • Exercise-induced asthma (EIA) - FEV1 • Interstitial lung disease (ILD)- SAT • Exercise tolerance in rehabilitation (COPD) - cardiopulmonary exercise (CPX). Important variables: - work rate (watts), SpO2, ABG - VO2, VCO2, RQ, VE - lactate threshold (LT) - breathing reserve (1-VEmax/MVV) - heart rate reserve (1-HRmax/220-age)

  20. Mechanism of exercise-induced hypoxaemia

  21. Noninvasive determination of lactate threshold by the V-slope method

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