Pulmonary Function Testing (PFT)

1. Spirometry (flow volume loop pre and post salbutamol) (FEV1, FVC)
  • Detecting obstructive airways disease and reversibility post bronchodialator.
  • Assesses small airways / peripheral airflow, which may help provide early diagnosis of airflow obstruction from smoking.

2. Lung Volumes Test (TLC,FRC,RV)
  • Detects restrictive lung diseases vs. obstructive lung disease.
  • Detects hyperinflation

3. Oxygen Diffusion Capacity Test (DLCO)
  • Assesses oxygen diffusion capabilities across alveoli/pulmonary capillary membrane. For example, emphysema and lung fibrosis vs. asthma and chronic bronchitis.

4. Airway Resistance Test
  • Measures resistance to airflow
  • Resistance in most cases will be increased with COPD, and asthma.

Indications That Require Pulmonary Function Testing
  • Evaluation of smokers over age 40 (dx of C.O.P.D. requires at least one P.F.T.)
  • Dyspnea with exertion or at rest
  • Chronic cough or sputum production
  • Chest tightness and/or exercised-induced cough
  • Frequent "cold", "hay fever" or allergies rhinitis
  • Management of patients receiving bronchodialator therapy
  • Evaluation of acute asthmatic incident
  • Documentation of pulmonary disability
  • Know exposure to pulmonary irritants or disease causing substances
  • Pre-surgical testing for:
    • Scheduled thoracic or upper abdominal surgery
    • Anticipated lengthy anesthesia
    • History or smoking
    • Cough or wheezing
    • Age greater than 70 years old
    • Know pulmonary disease and obesity

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