The first two editions of Interpretation of Pulmonary Function Tests were well-received andmet our goal of appealing to a wide, varied audience of health professionals.
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In this, the third edition,we have added a section to Chapter 7 on the forced oscillation technique for measuring respiratory system resistance, a procedure that has become popular in recent years. Other additions include a discussion in Chapter 5 of the measurement of exhaled nitric oxide, which is becoming useful in the study of asthma. The most recent guidelines (2005) on standardization of pulmonary function testing and interpretation published by the American Thoracic Society/European Respiratory Society Task Force have been added to Chapter 14. Spirometry: Dynamic Lung Volumes Spirometry is used to measure the rate at which the lung changes volume during forced breathingmaneuvers. The most commonly performed test uses the forced expiratory vital capacity (FVC) maneuver, in which the subject inhales maximally and then exhales as rapidly and completely as possible. Of all the tests considered in this book, the FVC test is both the simplest and the most important. Generally, it provides most of the information that is to be obtained from pulmonary function testing. It behooves the reader to have a thorough understanding of this procedure. 2A.
SPIROGRAMS AND FLOW-VOLUME CURVE
The twomethodsof recording the FVCtest are shownin Figure 2-1. In Figure 2-1A, the subject blows into a spirometer that records the volume exhaled, which is plotted as a function of time, the solid line. This is the classic spirogram showing the time course of a 4-L FVC. Two of themost commonmeasurementsmade from this curve are the forced expiratory volume in 1 second (FEV1) andthe average forced expiratory flow rate over the middle 50% of the FVC (FEF25–75). These are discussed later in this chapter. The FVC test can also be plotted as a flow-volume (FV) curve, as in Figure 2-1B. The subject again exhales forcefully into the spirometer through a flowmeter that measures the flow rate (in liters per second) atwhich the subject exhales. The volume and the rapidity at which the volume is exhaled (flow in liters per second) are plotted as the FV curve. Several of the commonmeasurements made from this curve are discussed later in this chapter.
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