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Sarthak Jain Shailendra Singh ANAECON INDIA HEALTHCARE PVT. LTD P-13, M.I.G. FLATS,PRASAD NAGAR,  NEW DELHI – 110 005
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
TV IRV ERV FRC RV VC FRC = ERV + RV TLC = ERV + RV + TV + IRV
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry preparation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* All flows and volumes are standardized to BTPS, i.e. related to expiratory air .  BTPS =  B ody  T emperature,  P ressure,  S aturated with water vapour Only calibrated spirometers can be relied upon!   Calibration of pneumotachographs daily or after replacement!
Cleaning / Hygine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Disposable bacteria filter (MicroGard)
Cleaning / Hygine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cleanliness regulations for contaminated components
Preparation of Spirometry Parameters measured in standing position are not better than in sitting position but different ! www.spiro-webCard.de Head straight or in slight extension Upright sitting position ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Quality Check Partial effort dependent (determined by the leastic recoil of the lung)  Steepness of the volume acceleration phase can be achieved from every patient independent of disease and degree of disease. Volume    Flow-  acceleration  limitation   End-expiratory phase Effort - dependent A: Maximal effort B: Submaximal effort C: Low effort A: Maximal effort B: Exhalation not complete A: Maximal effort B: Submaximal effort 1 2 3 Flow [L/s]    Volume [L] TLC     Effort dependent  RV A B C A B A B
Quality Check Patient should exhale suddenly and forced. Patient should exhale  suddenly and forced Patient should cough before starting the measurement Patient should inhale longer and to the maximum Patient should exhale as long as possible; minimal 6 s Different reasons;  more details in next slight www.spiro-webCard.de
Quality Check    IVC = 3%    FEV1 = 2%    IVC = 15%    FEV1 = 14% Acceptable  repeatability Insufficient  repeatability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Interpretation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Differentiation between Restriction and Obstruction! narrowing  of airways VC   contraction of  alveolar tissue FEV1  
Staging Obstructive parameters FEV1 / IVC < 5% Percentile of predicted (< 70% pred.) Recommendations of German „Atemwegsliga“  2005 I Mild FEV1  > 70%  pred. II Moderate FEV1  60 - 69%  pred. III Moderate severe FEV1  50 - 59%  pred. IV Severe FEV1  35 - 49%  pred. V Very severe FEV1  < 35%  pred.
Staging of Restrictive parameters TLC < 5% Percentile of predicted (< 80% pred.) Recommendations of German „Atemwegsliga“  2005 I Mild IVC  > 70%  pred. II Moderate IVC  60 - 69%  pred. III Moderate severe IVC  50 - 59%  pred. IV Severe IVC  35 - 49%  pred. V Very severe IVC  < 35%  pred.
Spirometry interpretation ,[object Object],[object Object],[object Object],[object Object],Normal case Upper point of inflection acute-angled Nearly vertical  ascent Exhalation (FVC) and  Inspiration (IVC) nearly identical Normal Case
Spirometry interpretation Mild obstructiv: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry interpretation Moderate to server Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry interpretation Severe obstructive Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry interpretation Restrictive Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spirometry interpretation ,[object Object],[object Object],[object Object],[object Object],Extrathoracic Case
Spirometry interpretation Intrathoracic Case ,[object Object],[object Object],[object Object],[object Object]
Spirometry interpretation Pre - Post Cases COPD Asthma    FEV1 < 12%     FEV1 >= 12%
 

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Anaecon India - Spirometery

  • 1. Sarthak Jain Shailendra Singh ANAECON INDIA HEALTHCARE PVT. LTD P-13, M.I.G. FLATS,PRASAD NAGAR, NEW DELHI – 110 005
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. TV IRV ERV FRC RV VC FRC = ERV + RV TLC = ERV + RV + TV + IRV
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16. Quality Check Partial effort dependent (determined by the leastic recoil of the lung) Steepness of the volume acceleration phase can be achieved from every patient independent of disease and degree of disease. Volume Flow- acceleration limitation End-expiratory phase Effort - dependent A: Maximal effort B: Submaximal effort C: Low effort A: Maximal effort B: Exhalation not complete A: Maximal effort B: Submaximal effort 1 2 3 Flow [L/s] Volume [L] TLC Effort dependent RV A B C A B A B
  • 17. Quality Check Patient should exhale suddenly and forced. Patient should exhale suddenly and forced Patient should cough before starting the measurement Patient should inhale longer and to the maximum Patient should exhale as long as possible; minimal 6 s Different reasons; more details in next slight www.spiro-webCard.de
  • 18.
  • 19.
  • 20. Staging Obstructive parameters FEV1 / IVC < 5% Percentile of predicted (< 70% pred.) Recommendations of German „Atemwegsliga“ 2005 I Mild FEV1 > 70% pred. II Moderate FEV1 60 - 69% pred. III Moderate severe FEV1 50 - 59% pred. IV Severe FEV1 35 - 49% pred. V Very severe FEV1 < 35% pred.
  • 21. Staging of Restrictive parameters TLC < 5% Percentile of predicted (< 80% pred.) Recommendations of German „Atemwegsliga“ 2005 I Mild IVC > 70% pred. II Moderate IVC 60 - 69% pred. III Moderate severe IVC 50 - 59% pred. IV Severe IVC 35 - 49% pred. V Very severe IVC < 35% pred.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29. Spirometry interpretation Pre - Post Cases COPD Asthma  FEV1 < 12%  FEV1 >= 12%
  • 30.  

Notas del editor

  1. The use of NIV in acute hospital settings and at home has been steadily increasing