Spirometry test

In a study by MacEwen et al. (1970) using seven adult human volunteers, 10-min exposure to monomethylhydrazine (90 ppm, or 169 mg/m3) resulted in irritation of the eyes, nose, and throat but did not cause excessive lacrimation or coughing. Clinical chemistry parameters for 60 d following the exposure were not significantly affected a 3-5% increase in Heinz body formation at d 7 declined after 2 w. Additionally, spirometry tests revealed no exposure-related effects. 

A spirometry test is a breathing test in which a person takes as deep a breath as possible and blows out quickly and completely into a tube cormected to a spirometry machine (Table 3.1). Lung measurements obtained from fhis fesf include forced expiratory volume in one second (FEVi), fhe amounf of air blown ouf in one second forced vifal capacify (FVC), fhe fofal amounf of air blown ouf fhe FEVi/FVC ratio and fhe... 

Bronchodilator trial When a spirometry test Reversible airways... 

An inhalable medication that relaxes the muscles in the airways (bron-chodilator) is frequently administered when airways obstruction is identified. In this bronchodilator trial test, the spirometry test is subsequently repeated and compared to the results from the initial spirometry test. If there is substantial improvement in lung function with the administration of the bronchodilator, the airways obstruction is reversible. An example of a lung disease with reversible airways obstruction is asthma, in which s)nnptoms occur episodically when airways obstruction occurs. If there is little or no improvement after the administration of the bronchodilator, the airways obstruction is fixed. An example of a limg disease with fixed airways obstruction is BO, where there is scarring of the airways. 

In work-aggravated asthma, a worker with preexisting asthma has worsening of asthma symptoms due to exposures in the workplace. These exposures may be irritant chemicals, cold air, or allergens to which the worker was sensitized prior to hire. The diagnosis is made if the asthma was not active within 2 years before the hire date and there is (1) worsening of asthma symptoms on workdays and (2) serial spirometry tests and /or repeat PEER measurements suggesting a work-related pattern. 

Quality spirometry is required both to minimize the number of workers who are inappropriately referred to pulmonologists for evaluation and to identify workers who may have decreased lung function compared to their baseline spirometry test. Poor coaching by the spirometry technician may... 

After 48 hours she has some spirometry tests which show ITV, (L) >20% increase after salbutamol. After 72 hours in hospital Ms RJ is ready for discharge. Medication on discharge is suggested to be ... 

Aimual spirometric evaluations will be conducted by the Safety Division on all employees filling job classifications requiring the use of respirators in the performance of their duties. Spirometry testing will be used to measure forced vital capacity (FVC) and forced expiratory volume-1 second (FEVi). If FVC is less than 75% and/or FEVj is less than 70%, the employee will not be allowed to wear a respirator unless a written waiver is obtained from a medical... 

Evaluation of basic and instrumental activities of daily living Evaluation of serum albumin Periodic spirometry testing... 

Spirometry A test method used to evaluate lung function that measures volume of exhaled air passing through a tube during a given time. 

The accurate diagnosis of AIA can be established by oral, inhaled, nasal or intravenous placebo-controlled provocations tests with increasing doses of aspirin [10], There is no reliable in vitro test. Oral challenges are most commonly performed, because the oral route mimics natural exposure and the test does not require special equipment, except simple spirometry. The threshold dose of aspirin which provokes a 20% fall in FEVi (positive reaction) will vary with individual patients, depending... 

Spirometry, an objective measure of pulmonary function, can be used to assist in confirming the diagnosis of asthma. The primary pulmonary function tests used to assist in the diagnosis of asthma are the forced expiratory volume in... 

Assessment of diurnal variation of PEF may be useful in patients who have asthma symptoms and normal spirometry. When spirometry is equivocal, a 20% or greater decrease in FEV after the administration of methacholine is diagnostic for asthma. A negative bronchoprovocation test with methacholine may help rule out asthma. 

A suspected diagnosis of COPD should be based on the patient s symptoms and/or history of exposure to risk factors. Spirometry is required to confirm the diagnosis. The presence of a postbronchodilator FEV,/FVC ratio less than 70% [the ratio of FEV, to forced vital capacity (FVC)] confirms the presence of airflow limitation that is not fully reversible.1,2 Spirometry results can further be used to classify COPD severity (Table 12-1). Full pulmonary function tests (PFTs) with lung volumes and diffusion capacity and arterial blood gases are not necessary to establish the diagnosis or severity of COPD. 

Spirometry Measurement of inhaled and exhaled volumes and flow rates of gas from the lungs. Pulmonary function tests obtained from spirometry are used to aid in the diagnosis of obstructive and restrictive airway diseases. 

Spirometry demonstrates obstruction (forced expiratory volume in 1 second [FEVJ/forced vital capacity less than 80%) with reversibility after inhaled P2-agonist administration (at least a 12% improvement in FEVj). Failure of pulmonary function to improve acutely does not necessarily rule out asthma. If baseline spirometry is normal, challenge testing with exercise, histamine, or methacholine can be used to elicit BHR. 

Contact allergy to glucocorticoids is not rare in patients with atopic dermatitis. In patients with known contact allergy to budesonide, allergic skin reactions can also occur when inhaled forms of the drug are used, as shown by a randomized, double-bhnd, placebo-controlled study in 15 non-asthmatic patients with budesonide hypersensitivity on patch testing (101). In four of seven patients who used inhaled budesonide, there was reactivation of the 6-week-old patch test sites and they had new distant skin lesions. No flare-up reactions were observed in the other 11 patients (three had used inhaled budesonide and eight placebo for 1 week). None of the patients developed respiratory symptoms spirometry and peak expiratory flow rates remained normal. 

Respiratory Lung function Spirometry and pulmonary function testing (measurements of lung volumes and flow rates) peak expiratory flow rate measurements (can be done in field with inexpensive hand-held meters)... 

Other tests which would be helpful in this woman would be FEV1( FVC and blood gases. The spirometry values provide data not only on the expiration of air but also on the time taken for forced expiration. Patients with significant airway limitation will show a prolonged forced expiratory time. The FEVj expressed as a percentage of the FVC provides a measure of the extent of airway limitation. In normal subjects it would be in the region of 75%. In patients with obstruction, the ratio FEVj/FVC will be reduced. 

The VC in COPD may be greater than the FVC, because of floppy airways. Spirometry does not distinguish between airflow obstruction due to asthma and COPD, but in conjunction with reversibility testing it can do so. FEV can therefore be diagnostic, assess severity and prognosis and monitor progression of disease. 

Q2 There is a wide range of respiratory function tests available many can be performed using spirometry or simple equipment such as the peak flow meter. The tests are used to aid the diagnosis of the respiratory disorder present, to follow the course of the disease, which may be recurrent or progressive, and to monitor the effects of therapy. In addition, there are specific occupational lung diseases, for which patients who have a respiratory disability, because of adverse conditions at the workplace, may claim some financial compensation. Their compensation depends on the extent of their respiratory disability. 

Effect. There are no chemical analytical methods recognized for measuring asbestos-induced health effects in humans. Clinical methods (x-ray, spirometry) for evaluating effects are discussed in Chapter 3. Development of sensitive and specific chemical or biochemical tests for asbestos-induced effects would be very valuable, especially if preclinical changes could be detected. 

Aspirin hypersensitivity is relatively common in adults (about 20%). Estimates of the prevalence of aspirin-induced asthma vary from 3.3 to 44% in different reports (SEDA-5,169), although it is often only demonstrable by challenge tests with spirometry, and only 4% have problems in practice. Patients with existing asthma and nasal polyps or chronic urticaria have a greater frequency of hypersensitivity (76), and women appear to be more susceptible than men, perhaps particularly during the childbearing period of life (77). Acute intolerance to aspirin can develop even in patients who have taken the drug for some years without problems. 

Pew data on the acute toxicity of NMP in humans are available. Volunteers exposed to <12 ppm NMP for 8 h did not experience any eye or respiratory tract irritation, symptoms such as headache, dizziness, or nausea, or changes in pulmonary function measured by spirometry. At 12 ppm NMP, two of six subjects reported an acetone-like odor. NMP did not produce signs of sensitization in a repeated-insult patch test with NMP, although a minor and transient irritation was observed. 

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