SPIROMETRY

Blow to know

Dr.Johan BuffelsBelgian Primary CareRespiratory Group

BPCRG Belgian Primary Care Respiratory Group Domus Medica (wetenschappelijke

vereniging van vlaamse huisartsen) Société Scientifique de Médecine

Générale University Departments of General

Practice

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

Hand-held spirometer

Spirometer in the fifties..

In the lung function lab

Spirobank

Simplicity

SpiroPro

SpiroStar

Datospir 70

Many types are available..

MicroLoop

What do we measurewith a spirometer?

5 10 15

2

4

6

8

Time (s)

Vo

lum

e (

L)

Normal spirogram: Volume / time

Man 176 cm76 kg

FVC

FEV1

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.

Spirometry: Normal and COPD

0

5

1

4

2

3

Lit

er

1 65432

FVC

FVC

FEV1

FEV1

Normal

COPD

3.900

5.200

2.350

4.150 80 %

60 %NormalCOPD

FVCFEV1 FVCFEV1/

Seconds

0

-4

-8

4

8

12

Flo

w (

L/s

)

PEF

Normal spirogram: Flow/Volume

Man 176 cm76 kg

Volume (L)

Spirometry and ageing

0 1 2 3 4 5 60

2

4

6

8

10

Vol (l)

Flow

(l/s

)25 yrs175 cmmale

75 yrs171 cmmale

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)

Reversibility Testing If airflow obstruction is present, the

test person is given a bronchodilator (inhalation device)

Reversibility testing

Short acting 2 agonist

Bronchodilators

FEV1

FVC

PEF

2.61

5.25

6.49

Pre

+ 12-15 % in FEV1 > 200ml improvement is

considered significant

3.95

6.08

9.64

51%

16%

49%

Post

2

6

10

2 4 6

Vol ( L )

Flo

w (

L/s

)

Reversibility Testing

Airflow obstruction disappears: REVERSIBLE OBSTRUCTION (probably asthma)

Airflow obstruction remains: IRREVERSIBLE OBSTRUCTION (probably COPD)

A children’s game?

But needs a maximal effort

Where can I get spirometry?

Hospital services Pneumologist Many general practitioners

new technique for primary care

Lung function lab

Telemedicine?

Know your numbers!

Blood pressure Cholesterol and glycemia FEV1 [= ESW = VEMS]

and FVC [= (geforceerde) vitale capaciteit ] [= capacité vitale (forcée)]

SPIROMETRY

Is a safe and simple test Provides useful data Is underused until now…

Blow to know !