PFTS are like ECG of the lungs. It gives an objective evidence of lung function due to disease process involving tracheobronchial tree, Pulmonary vasculature and chest bellows. It also helps in preoperative evaluation and helps to identify or exclude respiratory cause of breathlessness.
It helps in the assessment of the disease over the time like COPD and ILDs. It helps to monitor effectiveness of the therapy undertaken in BRONCHIAL ASTHMA. It also helps to detect airway hyperresponsiveness and help in evaluation of disability. PFTs mainly includes Spirometry, Peak Expiratory Flow Rate(PEFR), Body Plethysmography, Diffusion Lung Capacity, Cardio- Pulmonary Exercise Testing, 6 Minutes Walk Test & Arterial Blood Gas Analysis.
SPIROMETRY
ROLE IN COPD
Smokers, bio fuel users and people exposed to air pollution are at highest risk of developing COPD. Since COPD is potentially progressive and fatal disease, early diagnosis and treatment is very important.
Early symptoms are cough and sputum production. Unfortunately most smokers take these as normal phenomenon of smoker’s cough and do not seek medical attention. They usually consult doctors only when they feel dyspnea which is a late symptom of COPD.
The best indicator of COPD is spirometry. Ideally Spirometry test should be done in all smokers and repeated annually in abnormal reports and repeated every three yearly in normal reports.
Spirometry assisted counselling is an excellent tool in COPD patients for smoking cessation.
ROLE IN ASTHMA
Spirometry is carried out at initial diagnosis of asthma, after treatment started and stabilized symptoms to document attainment of near normal airway function and every 1 to 2 yearly to assess maintenance of airway function.
Detect sub-clinical abnormalities in high risk individuals like smokers, occupational exposures, chest wall deformity, etc.
To assess the post-operative complications in high risk patients those who are about to undergo a thoracic or abdominal surgery.
PEAK EXPIRATORY FLOW RATE
It is a test that measures how fast a person can exhale (breathe out).
It checks lung functioning, and is often used by patients who have asthma.
The flow of exhaled air from the lungs may be restricted due to inflammation or congestion from excess mucous.
PEFR is measured by peak flow meter.
INDICATIONS
Bronchial asthma : 20% increase in PEFR after bronchodilator is diagnostic.
Indentification of trigger factors in asthma
Monitoring severity of asthma
Therapy and self management of asthma
Evaluation of dyspnoea and as a bedside pulmonary function test
ADVANTAGES
- Inexpensive
- Easy to use in all age groups except in ≤ 6 years of age.
- Portable handheld device – so, useful in industrial workers for diagnosis of occupational asthma.
- Non-invasive method for lung function assessment- so, can be used in PHCs along with anthropometric measurements (i.e. height, weight, etc.)
IMPULSE OSCILLOMETRY
Spirometry is currently the most commonly performed lung function test in clinical practice and is considered to be the gold standard diagnostic test for asthma and COPD.
However, spirometry is not an easy test to perform because the forceful expiratory and inspiratory manoeuvres require good patient co-operation.
Children aged <5 years, elderly people and those with physical and cognitive limitations cannot perform spirometry easily.
ADVANTAGES OF IOS (IMPULSE OSCILLOMETRY)
- Patient needs to perform simple tidal breathing manoeuvres that require less effort and co-operation than spirometry, meaning that children and the elderly can therefore perform this test easily.
- It can be performed in patients on ventilators and also during sleep.
- One of the most remarkable features of IOS in relation to spirometry is that it has much greater sensitivity to detect peripheral airways obstruction.
- IOS are more sensitive instruments to detect small airways obstruction in patients with asthma and chronic obstructive pulmonary disease (COPD)
- IOS parameters seem to be able to pick up early changes in lung function such that they are superior to spirometry in predicting loss of control in asthmatic patients and possibly in identifying early airway disease in smokers.
* * * * *
Kolony Clinic is a subspecialty of internal medicine that deals with diseases of the lungs and the bronchial tubes, usually involving the evaluation of the upper respiratory tract (nose, pharynx and throat). This field is also known as chest medicine or respiratory medicine. The Clinic of Pulmonology is closely related to intensive care medicine, as it deals with patients requiring mechanical ventilation.
The clinic offers the best of technology and working environment to ensure the highest standards of patient care. Kolony Clinic has outstanding medical professionals with proven medical expertise in the field of pulmonary medicine and advanced respiratory care, capable of performing complex diagnostic and therapeutic procedures. The clinic offers expertise in diagnosis and management of diseases such as asthma, cystic fibrosis, chronic obstructive pulmonary disease (COPD), lung cancer, occupational respiratory diseases, Mycobacterium Avium Complex (MAC) lung disease, pulmonary fibrosis and sleep disorders.
Dr. Dhaval Darji (MBBS DTDC) is one of the immensely experienced Pulmonologist and specialists in Pulmonary Medicine from Ahmedabad.
AREA OF EXPERTISE:
- Asthma
- Severe Asthma with Fungal sensitisation
- Bronchiectasis
- Bronchitis
- Chronic Cough clinic(state of the art)
- Chronic Obstructive Pulmonary Disease (COPD)
- Common Cold
- Idiopathic Pulmonary Fibrosis
- Pneumonia
- Sleep Apnea
- Spirometry
- Tuberculosis
- Work-Related Asthma
- Allergy
KOLONY CLINIC
15-16, Vishwamitra Complex,
Opp. Kalupur Commercial Bank,
Nr. Sardar Patel Colony,
Stadium Road, Ahmedabad-14.
DR. DHAVAL DARJI
(MBBS DTCD)
Call for appointment: +91 94296 14760, +91 97224 82392
Source : by KOLONY CLINIC, Stadium Road, Ahmedabad.
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