By Robert E. Hyatt MD, Paul D. Scanlon MD, Masao Nakamura MD
- A new specialise in interpretation of complicated disorders
- Coverage of impulse oscillometry
- Solution web site to include textual content in addition to try generator to deal with cases
- "Pearls" concerning functionality or interpretation of key tests
- Carefully chosen authoritative references
- Clear illustrations demonstrating dozens of PFT patterns
- Illustrative cases
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Extra resources for Interpretation of Pulmonary Function Tests
Grading the severity of obstruction in mixed obstructive-restrictive lung disease. Chest 140:598–603, 2011. 7. Krowka MJ, Enright PL, Rodarte JR, Hyatt RE. Effect of effort on measurement of forced expiratory volume in one second. Am Rev Respir Dis 136:829–833, 1987. indd 34 30/01/14 10:36 AM 4 Diffusing Capacity of the Lungs An important step in the transfer of oxygen from ambient air to the arterial blood is the process of diffusion, that is, the transfer of oxygen from the alveolar gas to the hemoglobin within the red cell.
1 gives: PB VF = (PB + ∆P)(VF − ∆V) Piston and: Simplifies to: VF = ∆V (PB + ∆P) ∆P VF = ∆V (PB) ∆P FIG. 3-6. The subject is seated in an airtight plethysmograph and the pressure in the plethysmograph (Ppleth) changes with changes in lung volume. When the subject stops breathing, alveolar pressure equals barometric pressure (Pb). Consider what happens if the valve at the mouth is closed at the end of a quiet expiration, that is, FRC, and the subject makes an expiratory effort. Alveolar pressure increases by an amount (ΔP) that is measured by the mouth gauge, P.
On the basis of these considerations, conditions that reduce the diffusing capacity can be determined (Table 4-1). The major ones are listed here. indd 37 30/01/14 6:03 PM 38 4 n Diffusing Capacity of the Lungs TABLE 4-1. Emphysema: Although lung volume is increased, alveolar walls and capillaries are destroyed, and thus, the total surface area is reduced. Reduction of the Dlco in a patient with significant airway obstruction strongly suggests underlying emphysema. Lung resection: If only a small portion of the lung is resected (such as a lobe in an otherwise healthy patient), capillary recruitment from the remaining normal lung can result in an unchanged Dlco.