spirometrie
TRANSCRIPT
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