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SPIROMETRY

SPIROMETRY. Blow to know Dr.Johan Buffels Belgian Primary Care Respiratory Group. BPCRG. Belgian Primary Care Respiratory Group Domus Medica (wetenschappelijke vereniging van vlaamse huisartsen) Société Scientifique de Médecine Générale

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SPIROMETRY

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  1. SPIROMETRY Blow to know Dr.Johan Buffels Belgian Primary Care Respiratory Group

  2. BPCRG • Belgian Primary Care Respiratory Group • Domus Medica (wetenschappelijke vereniging van vlaamse huisartsen) • Société Scientifique de Médecine Générale • University Departments of General Practice

  3. What is Spirometry? • a simple and safe test • that measures lung volumes • with a graphical display • gives an estimation of lung function • Allows for diagnosis of airflow obstruction • Permits good follow-up for asthma and COPD

  4. Hand-held spirometer

  5. Spirometer in the fifties..

  6. In the lung function lab

  7. Spirobank Many types are available.. Simplicity MicroLoop SpiroPro SpiroStar Datospir 70

  8. What do we measurewith a spirometer?

  9. 8 6 Volume (L) FVC 4 FEV1 2 5 10 15 Time (s) Normal spirogram: Volume / time Man 176 cm 76 kg

  10. Two important parameters • FVC - Forced Vital Capacity. This is the total amount of air that you blow out in one breath. • FEV1 - Forced Expiratory Volume in one Second. This is the amount of air you can blow out within one second. With normal lungs and airways you can normally blow out most of the air from your lungs within one second.

  11. Spirometry: Normal and COPD

  12. 12 8 4 0 -4 -8 Normal spirogram: Flow/Volume PEF Man 176 cm 76 kg Flow (L/s) Volume (L)

  13. 75 yrs 171 cm male Spirometry and ageing 25 yrs 175 cm male

  14. Spirometry allows for • Early detection of airflow obstruction (often late signs and symptoms) • Better diagnosis (helps to distinguish between asthma and COPD) • Correct follow-up (compare with blood pressure meter in hypertension patients)

  15. Reversibility Testing • If airflow obstruction is present, the test person is given a bronchodilator (inhalation device)

  16. Reversibility testing Short acting 2 agonist

  17. Bronchodilators  Pre Post FEV1 FVC PEF 2.61 5.25 6.49 3.95 6.08 9.64 51% 16% 49% 10 6 Flow (L/s ) 2 + 12-15 % in FEV1 > 200ml improvement is considered significant 2 4 6 Vol ( L )

  18. Reversibility Testing • Airflow obstruction disappears: REVERSIBLE OBSTRUCTION (probably asthma) • Airflow obstruction remains: IRREVERSIBLE OBSTRUCTION (probably COPD)

  19. A children’s game?

  20. But needs a maximal effort

  21. Where can I get spirometry? • Hospital services • Pneumologist • Many general practitioners • new technique for primary care • Lung function lab

  22. Telemedicine?

  23. Know your numbers! • Blood pressure • Cholesterol and glycemia • FEV1 [= ESW = VEMS] • and FVC [= (geforceerde) vitale capaciteit ] [= capacité vitale (forcée)]

  24. SPIROMETRY • Is a safe and simple test • Provides useful data • Is underused until now… Blow to know!

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