spirometrie

TESTE SPIROMETRICE

IMPORTANTA PRACTICA (1)

• a crescut frecventa bolilor pulmonare - bronsita cronica - astmul bronsic - fibrozele pulmonare

• Gradul disfunctiei pulmonare coreleaza cu perspectiva de viata

TESTE SPIROMETRICE

IMPORTANTA PRACTICA (2)

•Noile clase de substante bronhodilatatoare necesita evaluari obiective

• Extinderea chirurgiei toracice creste nevoia de expertizare a bolnavilor pulmonari

TESTE SPIROMETRICE

OBIECTIVE(1)

1. Depisteaza in stadiul subclinic : - bolile pulmonare - insuficienta respiratorie

2. Caracterizeza IR

3. Stadializeaza IR

TESTE SPIROMETRICE

OBIECTIVE (2)

4. Evalueaza raspunsul terapeutic

5. Apreciaza evolutia

6. Determina prognosticul

7. Stabileste riscul operatori

TESTE SPIROMETRICE

1.Volume

2.Debite

3.Distributie

4.Elasticitate

5.Difuziune

TESTE SPIROMETRICE

6.Circulatie

7.Raport V / P

8.Gaze Sangvine

9.Teste Provocare Bronsica

EXPLORARI MINIMALE

• Volume

• Debite

• Difuziune alveolo-capilara

• Teste de provocare bronsica

PARAMETRII SPIROMETRICI

FEV1 = Forced Expiratory Volume In 1sec = VEMS

PEF = Peak Expiratory Flow = Flux Expirator de Varf

VC = Vital Capacity = Capacitate Vitala

PARAMETRII SPIROMETRICI

FVC = Forced Vital Capacity = Capacitate Vitala Fortata

FER = Forced Expiratory Rate = FEV1 / VC = Ind. TIFNEAU

F50 = Forced Expiratory Rate at 50%

F25 = Forced Expiratory Rate at 25% MEF = Mid Expiratory Flow

VOLUM INSPIRATOR REZERVA

CAPACITATEVITALA

VOLUM EXPIRATORREZERVA

VOLUMREZIDUAL

CAPACITATEINSPIRATORIE

CAPACITATEREZIDUALAFUNCTIONALA

CAPACIT.VITALA

CAPACIT.PULMONTOTALA

VR

VER

VC

VIR

NORMAL

CPT

CVCI

CRFVR

VER

VC

VIR

CPT

CV CI

CRF

OBSTRUCTIV

VR

VER

VC

VIR

CPTCV

CI

CRF

RESTRICTIV

1 2 3 4 sec

t

V mlVEMS (FEV)

VEMSFLUX 25-75%

25%

NORMALVEMS1/CV>70%VEMS3>95%FEF 25-75%: variabil

75%

CVVC

1 2 3 4 sec

t

V ml

VEMS(FEV)

25%VEMS

FLUXCV25-75%

75%

OBSTRUCTIV-VEMS1/CV<70%-VEMS3/CV<95%-FEF 25-75%:

CVVC

Vml

t

1 2 3 4

RESTRICTIV-VEMS1/CV>70%-VEMS/CV>95%-FEF25-75%:N sau

8-

6-

4-

2-

NORMAL

RESTRICTIV

OBSTRUCTIV

125% 100% 75% 50% 25% VOLUM 2

FLUXUL l

FLUXl/sec Peak flow

V max 50%

V max 75%

TCL 25% 50% 75%

9-

6-

3-

NORMALASTM IN CRIZA

ASTM IN REMISIUNE

EXPIR

INSPIR

FL

UX

VOLUM

CPT VR

FL

UX

VOLUM

FL

UX

VOLUM

CPTVR

CPTVR

VARIABILA EXTRATORACICA

VARIABILA INTRATORACICA

CURBE FLUX – VOLUMTIPURI DE OBSTRUCTIE

1. METODA DILUTIEI HELIULUI IN CIRCUIT INCHIS

Vspipom.x(He in – He fin CRF= He Fin

2. METODA PLETISMOGRAFICA ΔP pletismCRF= P atm X Δ P gura

3. METODA ELIMINARII AZOTULUI IN CIRCUIT DESCHIS

MASURAREA CRF si a VR