1. Espirometria

Repetibilidad criterios

________: Una vez que se hayan obtenido tres maniobras aceptables, se deben elegir las dos maniobras más grandes mediante la suma del volumen de FVC y FEV1, y entre ellas su FVC y VEF1 deben diferir en menos de 150 ml, excepto que si la FVC es inferior a 1 L, la diferencia debe ser inferior a 100 ml.

PEF

El ________ debe ir seguido de una trayectoria descendente suave y sin artefactos: sin tos, cierre de glotis, boquilla ocluida o evidencia de fugas de aire alrededor de la boquilla.

magnitud de pulmón

Mide los volúmenes ________ y la rapidez con la que se pueden movilizar (flujos de aire)

1 Diagnósticos

Indicaciones: ________: Evaluación de los síntomas, signos o pruebas de laboratorio alterados relacionados con la patología respiratoria.

Broncodilatador prueba

________: Si el patrón obtenido en la espirometría basal es obstructivo, se realiza una espirometría posbroncodilatadora.

broncodilatador respuesta

El ________ se describe como una «modificación significativa con un broncodilatador» en pacientes con insuficiencia respiratoria obstructiva, que requiere un aumento de ≥ 12% y 200 ml en el VEF1 y/o la CVF, en comparación con el valor basal.

volumen de retrógrado extrapolación

El ________ debe ser inferior a 150 ml o el 5% de la FVC en adultos.

espirometría informe

El ________ incluye las curvas flujo-volumen y volumen-tiempo, los valores obtenidos por el paciente en litros y su relación porcentual con los valores teóricos pronosticados para el paciente.

Obstructivo respiratorio trastorno

B. ________: Define la relación VEF1 /CVF según la LIN, la FVC igual o superior a su LIN (se debe considerar el valor más alto, ya sea la maniobra basal o la maniobra posbroncodilatadora) y el VEF1 puede estar bajo en su LIN o normal.

Spirometry Dr. Fabiola Salazar Maturana March 2019 Introduction

Spirometry is the oldest of the pulmonary function tests

First second forced expiratory volume (FEV1)

This is the maximum volume of air exhaled in the first second of a forced expiration, expressed in liters

Forced Expiratory Flow 25-75% (FEF 25-75%)

Corresponds to the central 50% of forced expiration (between 25% and 75%), expressed in L/s

2.-Control

Control of diseases that affect lung function

Others

work and disability, epidemiological, preventive

Very rare

syncope

Table 1

Recommended waiting time for forced spirometry after using bronchodilator medication

Description of the maneuver

The patient is connected to the mouthpiece of the spirometer, the nose is occluded with a nose clip

Values obtained

FVC, FEV1, FEV1/FVC Ratio, FEF 25-75%

Exam quality criteria

Spirometry will always involve a minimum of three satisfactory forced expiration maneuvers to achieve the criteria of acceptability and repeatability with a maximum of eight when they are not judged adequate

Acceptability criteria for starting the maneuver

Maneuvers performed according to the previous instructions with maximum effort

The PEF should be followed by a smooth descending path without artifacts

no cough, glottis closure, occluded mouthpiece or evidence of air leakage around the mouthpiece

End of Expiration Acceptability Criteria

Have reached the "plateau" (plateau) on the volume-time curve (very low expiratory flows < 0.025 L for at least 1 s) or final asymptotic type on the F/V curve

Repeatability Criteria

Once three acceptable maneuvers have been obtained, the 2 largest maneuvers must be chosen by the sum of the volume of FVC and FEV1, and between them their FVC and FEV1 must differ by less than 150 mL, except that if the FVC is less than 1 L, the difference must be less than 100 ml

Bronchodilator test

If the pattern obtained in basal spirometry is obstructive, post-bronchodilator spirometry is performed

If salbutamol cannot be used, the anticholinergic agent could be used

ipratropium bromide at a total dose of 160 μg, equivalent to 4 puffs of inhaler pressurized through a spacer chamber, but there is no proven evidence of the meaning or the level of significant change, so it is not possible to recommend its routine use as an alternative to salbutamol

Interpretation

It is important to remember that the spirometric report provided by the pulmonary function laboratory describes the functional interpretation of the results

Spirometric alteration patterns

a

Restrictive respiratory disorder

The FEV1/FVC ratio is normal and the FVC is below its LIN with a proportionately low FEV1

b. Obstructive respiratory disorder

It defines the FEV1/FVC ratio under the LIN, the FVC equal to or greater than its LIN (the highest value should be considered, either the basal maneuver or the post-bronchodilator maneuver) and FEV1 may be low in your LIN or normal

c. Obstructive respiratory alteration with reduced FVC

the FEV1/FVC ratio is low in your LIN, as are FVC and FEV1, the latter's drop being greater than that of FVC

Spirometry

Procedures manual

To be Chile Rev Chile Nurse Breathe 2018; 34

171-188 2

Spirometry

Procedures manual

Rev Chil Enf Respir 2007; 23

31-42 3

Eur Respir N 2005; 26

319-338