Patients with diseases of the respiratory system are often prescribed a function test external respiration(FVD). Despite the fact that this type of diagnosis is quite simple, accessible, and therefore widespread, few people know what it is and for what purpose it is carried out.

What is FVD and why measure it?

Breathing is a vital process for a person of any age. During the respiratory process, the body is saturated with oxygen and releases carbon dioxide formed during metabolism. Therefore, respiratory dysfunction can lead to a whole series health problems.

External respiration is medical term, which includes a description of the processes of air circulation through the system respiratory organs, its distribution, transfer of gases from inhaled air to the blood and back.

The study of respiratory function, in turn, allows you to calculate the volume of the lungs, assess the speed of their work, identify dysfunctions, diagnose diseases of the respiratory system and determine effective ways treatment. Therefore, doctors use FVD for various purposes:

1. For diagnostic purposes. In this case, the state of health, the effect of the disease on the functionality of the lungs and its prognosis are assessed. Also, the risk of developing pathology is determined (in smokers, people working in harmful conditions etc.).
2. For dynamic observation monitoring the development of the disease and assessing the effectiveness of therapy.
3. To provide the expert opinion required when assessing suitability for work in special conditions and determination of temporary disability.

Also, diagnostics of external respiration function is carried out within the framework of epidemiological studies and in order to implement comparative analysis health of people in different conditions life.

Indications and limitations for diagnosis

The reason for studying pulmonary function and assessing respiratory function are many diseases of the respiratory system. Carrying out similar diagnostics prescribed for:

• chronic bronchitis;
• asthma;
• infectious inflammatory process in the lungs;
• chronic obstructive pulmonary disease;
• silicosis ( occupational disease resulting from regular inhalation of dust from high content silicon dioxide);
• idiopathic fibrosing alveolitis and other pathologies.

Contraindications to FVD include:

• age less than 4 years – if the child is not able to correctly understand and follow the instructions of a health worker;
• development in the body acute infections and febrile conditions;
• severe angina and myocardial infarction;
• stable increase in blood pressure;
• stroke suffered shortly before the proposed study;
• congestive heart failure, which is accompanied by breathing problems even with low exertion and at rest.

Important. Also, this type of diagnosis is not carried out in patients suffering from mental or mental disorders. mental activity which do not allow them to adequately respond to requests from medical staff.

Spirometry

Currently, there are various methods for studying the function of external respiration. One of the most common is spirometry.

For research this kind use a dry or water spirometer - a device consisting of two components. The spirometer sensor records the volume of air inhaled and the speed at which the person inhales and exhales it. And the microprocessor processes information.

Spirometry allows you to evaluate:

• the functionality of the organs involved in breathing (including the vital capacity of the lungs);
• cross-country ability respiratory tract;
• complexity of changes in the respiratory system, their type.

In addition, it can be used to detect bronchospasms and determine whether changes in the respiratory system are reversible.

Survey process

In progress diagnostic study The patient is asked to inhale as deeply as possible and then exhale into the spirometer. Initially, measurements are taken in a calm state, and then during forced breathing. The process is repeated several times with short breaks. When assessing the result, the highest indicator is taken into account.

To determine the reversibility of the process of narrowing of the bronchi, spirometry is performed with a bronchodilator - a drug that dilates this respiratory organ.

Preparing for the study

All studies are usually carried out in the morning on an empty stomach, or two hours after a small breakfast.

In order for spirometry readings to be most accurate, the patient must prepare for it in advance. As part of the preparation, doctors recommend:

• quit smoking one day before;
• do not drink strong tea, coffee and alcoholic drinks;
• half an hour before the examination, exclude vigorous physical activity.

In some cases, medications that affect the functioning of the respiratory system are also stopped.

During diagnosis, the patient should wear loose clothing that does not interfere with breathing deeply.

Decoding the results

The average rate of breathing for a healthy person is:

• volume (DO) – from 0.5 to 0.8 liters;
• frequency (FR) – 10-20 times/min;
• minute volume (MOV) – 6-8 liters;
• expiratory reserve volume (ERV) – 1-1.5 l;
• vital capacity of the lungs (VC) – from 3 to 5 l;
• forced vital capacity (FVC) – 79-80%;
• volume of forced output for 1 second. (FEV1) – from 70% FVC.

In addition to these indicators, the instantaneous expiratory volumetric flow rate (IEF) is also determined. It is traced at different % filling of the lungs.

Important! Indicators of breathing volume and speed depend on the patient’s gender, age, weight and physical condition(training). Slight variability is allowed in each separate category subjects (no more than 15% of the norm).

Significant deviations from normal readings allow the doctor to determine which pathologies are occurring in the patient’s respiratory system. So, if the vital capacity indicator is 55% of the norm, and FEV1 is equal to 90%, then this indicates the development of restrictive disorders characteristic of pneumonia, alveolitis.

Evidence of chronic obstructive pulmonary disease, in turn, consider a slight decrease in vital capacity (up to 70%) against the background sharp decline OVF1 (up to 47%). Other respiratory dysfunctions also have characteristic indicators.

Bodyplethysmography

This test is similar in functionality to spirometry, but provides a detailed and full information about the state of the human respiratory system.

Body plethysmography helps to assess not only the patency of the bronchi, but also the volume of the lungs, as well as to recognize air traps that indicate pulmonary emphysema.

Such diagnostics are carried out using a body plethysmograph - a device consisting of a body camera (in which the subject is placed) with a pneumotapograph and a computer. The latter's monitor displays the study data.

Peak flowmetry

A diagnostic method that allows you to determine the rate of inhalation/exhalation, and thereby assess the degree of narrowing of the airways.

The study is of particular importance for those who suffer from bronchial asthma, as well as patients with obstructive pulmonary disease in chronic stage– it makes it possible to analyze the effectiveness of the chosen therapy.

Diagnostics is carried out using a special device - a peak flow meter. The first such apparatus in history was quite large and heavy, which significantly complicated research. Modern peak flow meters are mechanical (in the form of a tube, on which divisions with colored markers are applied) and electronic (computer), which are easy to use and compact. Moreover, the methodology itself for conducting and evaluating the results is so simple that it can be carried out at home.

But, despite this, the device should be used only on the recommendation of the treating doctor, and even better under his supervision (you can set up the peak flow meter together with the doctor, and then use it yourself, recording the readings). This approach will allow you to correctly take measurements and interpret the indicators.

Using a peak flow meter:

• changes in bronchial patency at different times of the day are determined;
• planned necessary treatment, the correctness and effectiveness of previous prescriptions is assessed;
• periods of exacerbation of asthmatic disease are predicted.

In addition, factors are identified that increase the risk of exacerbation (in cases where attacks occur frequently in some places and do not occur at all in others).

How the study is conducted and the results are evaluated

Before starting regular measurements, the peak flow meter is adjusted taking into account the normal values ​​of peak expiratory force (PEF), which depends on gender, age group and patient growth. When setting up, according to special tables, the boundaries of the areas (normal, alarming and unsatisfactory) are calculated.

For example, the norm for PSV in a man of middle age and height (175 cm) is 627 l/min. Normal area (it is marked on the device green) is at least 80% of the norm, that is, 501.6 l/min.

In alarming ( yellow) includes indicators from 50 to 80% (in the case under consideration from 313.5 to 501.6 l/min).

All values ​​below the alarm area limit will be marked as unsatisfactory (red).

Important. As an option for setting up the peak flow meter, the patient's spirometry indicators can be used (the best study indicator is taken as the basis).

Terms of use

To obtain the most complete picture, peak flowmetry is carried out twice a day - in the morning and at evening time. Special preparation for diagnosis is not required, but there are a number of rules that require strict adherence:

• diagnosis is carried out before taking medications;
• before starting the study, the pointer slider is set to the beginning of the scale;
• During measurements, the patient stands or sits (the back is straight);
• the device is held in a horizontal position with both hands (hands do not cover the slider and holes);
• First, inhale deeply and hold your breath for a short time, after which you exhale as quickly as possible.

Important. Each measurement is performed three times, with short breaks. The maximum reading of the device is recorded and noted in an individual chart, which the doctor subsequently becomes familiar with.

Additional Research

In addition to the basic research methods, to clarify the diagnosis or assess the effectiveness of treatment, doctors often use additional tests.

So, during spirometry tests are prescribed with:

• salbutamol;
• physical activity;
• methacholine.

Salbutomol is a drug with a bronchodilator effect. A functional test with it is carried out after control studies and makes it possible to determine whether the narrowing in the bronchi is reversible or not. It also gives a more accurate picture of the state of the respiratory system and makes it possible to clarify the diagnosis. So, if FEV1 improves after taking a bronchodilator, this indicates asthma. If the sample gives negative result- this speaks of chronic bronchitis.

Methacholine is a substance that provokes spasms (hence the name of the test - provocative test) and allows you to determine asthma with 100% accuracy.

As for exercise tests, in this case the second study is carried out after exercise on a bicycle or treadmill and allows you to determine exercise asthma with maximum accuracy.

A diffusion test is often used as an additional study. It allows you to assess the speed and quality of oxygen supply to the blood.

Reduced indicators in this case indicate the development of lung disease (and in an already quite advanced form), or possible thromboembolism of an artery in the lungs.

Understanding the structure and intricacies of the respiratory system is vital to human anatomy. To identify disorders in the respiratory system, it is carried out FVD study, also known as pulmonary function testing.

What is FVD?

To identify a disease such as asthma, the doctor must review symptoms and medical history, family history, and perform a pulmonary function test.

FVD studies are non-invasive tests that show how well your lungs are working.

The tests measure lung volume, capacity, flow rates and gas exchange. This information can help the doctor diagnose and make further treatment decisions. certain diseases lungs. Every person may need different type test, and doctors may order one or more pulmonary function tests, depending on the underlying problem.

There are several types of test:

1. spirometry: measures the amount of air consumed.
2. Plethysmography: Measures the volume of gas in the lungs, known as lung volume.
3. diffusivity test: evaluates how well the small air sacs inside the lungs, called alveoli, are working.

Available various reasons, which can be used to assess external respiration. It is sometimes performed as part of routine therapy in healthy people. But, usually, the procedure is performed in certain areas professional activities to ensure the health of employees (such as graphite plants and coal mines). Or if a doctor needs help diagnosing a health problem, such as:

• allergy;
• respiratory infections;
• breathing problems due to a chest injury or recent surgery;
• chronic disease: asthma, bronchiectasis, emphysema or chronic bronchitis;
• asbestosis is a lung disease caused by inhalation of asbestos fibers;
• restrictive airway problems due to scoliosis, tumors, inflammation or scarring of the lungs;
• sarcoidosis, a disease that causes accumulations of inflammatory cells around organs such as the liver, lungs and spleen;
• scleroderma is a disease that causes thickening and hardening of connective tissue.

These tests can be used to check lung function before surgery or other procedures in patients with lung or heart disease, smokers, or other conditions. Another use of the research is to evaluate treatments for asthma, emphysema and other chronic lung problems.

What does the FVD show?

EF tests may include tests that measure lung size and airflow, such as spirometry and lung capacity tests. Other tests measure how well gases, such as oxygen, move in and out of the blood. These tests include pulse oximetry and arterial blood gases.

Sometimes an extensive study of external respiratory function is required, including analysis of all indicators.

Another lung function test, called fractional exhaled nitric oxide (FeNO), measures nitric oxide, which is a marker of inflammation in the lungs. A patient may have one or more of these tests to make a diagnosis, compare lung function to expected levels of function, monitor whether the disease is stable or worsening, and check the effectiveness of treatment. The purpose, procedure, discomfort, and risks of each test will vary.

Main parameters in FVD studies:

• tidal volume (VT) – the amount of air consumed during normal breathing;
• minute volume (MV) – total quantity exhaled air per minute;
• total capacity - the volume of air that can be exhaled after inhalation, as far as possible;
• functional residual capacity (FRC) - the amount of air remaining in the lungs after normal exhalation;
• total lung volume when filled as much as possible a large number air;
• forced capacity (FVC) - the amount of air exhaled forcibly and quickly after inhalation, as far as possible;
• the amount of air emitted during the first, second and third seconds of the test;
• forced expiration (FEF) – average speed flow during the middle half of the dough;
• peak expiratory flow rate (PEFR) is the fastest rate at which air can be exhaled from the lungs.

Normal test values ​​vary from person to person. The results are also compared to any of your previous test results.

FVD and spirometry: what is the difference?

During spirometry, the patient will sit with a mouthpiece in front of the equipment. It is important that the mouthpiece fits tightly and that all consumed air enters the device.

Spirometry measures the amount of air inhaled: it only measures speed air flow and assesses lung size.

Also, the procedure involves using a nose clip so as not to inhale air through it. The doctor will ask you to inhale and exhale as deeply as possible, or to breathe faster for a few seconds. The doctor may also ask you to inhale a medicine that opens the airways. You will then need to breathe into the breathing machine again to see if the medicine affects your lung function.

In medicine, FVD studies determine the general and detailed analysis quality of lung function.

For example, lung capacity tests are the most accurate way to measure how much air the lungs can hold. This test determines the amount of gas in the lungs, known as lung capacity.

The diffusion capacity of the lungs determines how well oxygen gets into the blood of inhaled air. Pulse oximetry assesses the level of oxygen in the blood. Fractional exhaled nitric oxide tests measure the amount of nitric oxide in the air you exhale. Other tests may be needed to evaluate lung function in infants, children, or patients who are unable to perform spirometry and lung volume tests.

How is external respiration performed?

The test is performed on an outpatient basis. The way you perform the procedure may vary. This depends on the patient's condition and treatment methods.

The patient should describe in detail their symptoms (cough, shortness of breath, shortness of breath, chest tightness), including when and how often they occur.

In most cases, the procedure will be carried out as follows:

• the patient sitting in a chair will be asked to remove tight clothing, jewelry or other items that may cause breathing problems;
• then a soft clip will be placed on the nose to allow breathing directly through the mouth, and a sterile mouthpiece attached to the spirometer will be given;
• the person will need to tightly close their mouth with the mouthpiece;
• During the procedure, the doctor will carefully monitor the patient’s dizziness, breathing problems and other negative manifestations.

After certain tests, the person may be given a bronchodilator. The test will then be repeated a few minutes after it takes effect.

How to breathe correctly during respiratory function?

For the reliability of the FVD study, a number of regulatory conditions must be met. Before the procedure, you must take a horizontal position for 15 minutes. Tests include various studies, rarely limiting themselves to one, since only comprehensive testing allows a complete analysis of the position of the lungs.

The breathing required during testing depends on the type of test.

During spirometry, lung volume is measured by having the patient inhale and exhale naturally into the equipment.

During pneumotachography, the rate of air flow through the respiratory tract is analyzed. natural state, and the result of FVD with load is studied. When analyzing the vital capacity of the lungs, it is carried out intensively deep breath. Reserve capacity will be the difference between this indicator and lung volume.

Preparation for FVD examination

The patient will be asked to sign a consent form, which gives permission for the FVD procedure to be performed. The patient will need to tell the doctor that he is taking any medications, including over-the-counter drugs, vitamins and herbal supplements.

It is worth being prepared to adjust your intake of asthma medications: some of them may affect test results.

You also need:

• stop taking certain medications before the procedure if directed by your doctor;
• do not eat “heavy” food before the test;
• no smoking;
• Follow any other instructions your doctor gives.

Before taking a methacholine test, you should tell your doctor if you have recently had viral infection, for example, a cold. And also about recent vaccinations or immunizations, as this may affect the test results.

Where can I get an FVD test?

Nowadays, many clinics provide FVD studies. It is important that the clinic is equipped with advanced diagnostic equipment necessary for a high-quality study of respiratory function. It is also necessary that the clinic employ truly experienced diagnosticians and pulmonologists. Ensuring that the analysis is followed and that the results are reported accurately is important.

In the capital, the test can be carried out in one of the trusted centers - the Yusupov Hospital or the CELT clinic.

Cost of the FVD procedure

Price general research varies by region and averages 3,000 rubles. Typically, the first appointment, including examination and consultation with a pulmonologist, costs on average 1500-1800 rubles. Repeated - cheaper. Analysis of provoked tidal volumes on average it costs 1600 rubles. Analysis of tidal volumes using various drugs- about 800 rubles.

Norms of physical function in adults: decoding

Averages vary for each person. Doctors will look at the test results and compare them to typical averages for people of the same height, age, and gender to calculate a condition index.

There is a statement that a person's lungs grow until the age of 20, then their function begins to slowly decline. Height, gender and other factors are taken into account. Have more tall people and men tend to have larger lungs.

Sometimes doctors may do additional tests to confirm their findings before making a diagnosis.

Values ​​that are abnormal compared to other measurements may be a sign of a problem in the lungs. Individual results vary, so results are interpreted on a personal basis.

Positive Ventolin test: what does it mean?

The Ventolin test is quick, simple and painless method assessment of respiratory function. It takes about 60 minutes and is done for:

• detecting and confirming asthma, and monitoring the course of the disease.
• to distinguish asthma from COPD.

Ventolin is a medicine that is distributed in the respiratory system.

As a result of this test, an improvement is considered normal if the FEV1 value has increased by ≥200 ml and by ≥12% of normal (or the original value). In current protocols for the treatment of asthma and COPD, the result of Ventolin tests has no prognostic value, either with a long-term response to anti-inflammatory treatment or due to the progression of these diseases.

Based on practicality, the cardinal result of the test is normal indicators FEV1/FVC after the drug, excluding the diagnosis of COPD. Obstruction after the drug can occur in both COPD and asthma. In patients, the value of the Ventolin test may change over time. Having received the sample result, you need to analyze the data, drawing a conclusion about a possible pathology.

A healthy patient should have good basic indicators of the spirogram: forced vital capacity, air force and ventilation of the lungs at least 80% of the average values. If the indicators have decreased to 70%, then this is accepted as a pathology.

Pulmonary function testing is sometimes necessary after inhalation of drugs that are distributed in the respiratory system, for example, FVD with Methacholine. It can also be a spirometric study using medications, such as a bronchodilator test, for example, FVD with Salbutamol. If a test with Salbutomol has a questionable result, use a bronchodilator test with the drug Formoterol.

Assessment of external respiratory function (RPF) in medicine is a very important tool for drawing conclusions about the state of the respiratory system. FVD can be assessed different methods, the most common and more accurate of which is spirometry. Currently, spirometry is carried out using modern computer technology, which increases the reliability of the data obtained several times.

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Spirometry

Spirometry is a method for assessing external respiratory function (ERF) by determining the volumes of inhaled and exhaled air and the speed of movement of air masses during breathing. It is a very informative research method.

Spirometry should only be performed on the recommendation of a competent medical specialist.

Indications

To assess the function of external respiration, the following indications exist:

• diagnosis of respiratory system diseases (bronchial asthma, chronic obstructive pulmonary disease, chronic bronchitis, alveolites, etc.);
• assessment of the effect of any disease on the function of the lungs and airways;
• screening (mass examination) of people who have risk factors for developing pulmonary pathology (smoking, interaction with harmful substances, due to profession, hereditary predisposition);
• preoperative assessment of the risk of breathing problems during surgery;
• analysis of the effectiveness of treatment of pulmonary pathology;
• grade pulmonary function upon determination of disability.



Spirometry is an important method for diagnosing respiratory diseases

Contraindications

Spirometry is safe procedure.She doesn't have absolute contraindications, but forced (deep) exhalation, which is used when assessing respiratory function, should be performed with caution:

• patients with developed pneumothorax (presence of air in pleural cavity) and within 2 weeks after its resolution;
• in the first 2 weeks after the development of myocardial infarction or surgical interventions;
• with severe hemoptysis (blood discharge when coughing);
• for severe bronchial asthma.

Spirometry is contraindicated in children under 5 years of age. If it is necessary to assess respiratory function in a child under 5 years of age, a method called bronchophonography (BFG) is used.



Research methodology

To study the respiratory function, the patient needs to breathe for some time into the tube of a device called a spirograph. This tube (mouthpiece) is disposable and is changed after each patient. If the mouthpiece is reusable, then after each patient it is disinfected in order to prevent the transmission of infection from one person to another.

Spirometric testing can be carried out during quiet and forced (deep) breathing. The forced breathing test is carried out as follows: after a deep breath, the person is asked to exhale as much as possible into the tube of the device.

To obtain reliable data, the study is carried out at least 3 times. After obtaining spirometry readings medical worker should check how reliable the results are. If in three attempts the parameters of the respiratory function differ significantly, this indicates the unreliability of the data. In this case, additional recording of the spirogram is required.

All examinations are performed with a nose clip to prevent nasal breathing. If there is no clamp, the physician should ask the patient to pinch their nose with their fingers.

Preparing for the study

To obtain reliable survey results, you must follow some simple rules.

• Do not smoke for 1 hour before the test.
• Do not drink alcohol at least 4 hours before spirometry.
• Eliminate heavy physical activity 30 minutes before the test.
• Do not eat 3 hours before the test.
• The patient's clothing should be loose and not interfere with deep breathing.
• If the patient wears removable dentures, they should not be removed before the examination. Prostheses should be removed only on the recommendation of a doctor if they interfere with spirometry.

Spirometry indicators

To assess physical activity, there are the following main indicators.

• Vital capacity of the lungs (VC). This parameter shows the amount of air that a person can maximally inhale or exhale.
• Forced vital capacity (FVC). This is the maximum volume of air that a person is able to exhale after a maximum inhalation. FVC can decrease in many pathologies, but increases only in one - acromegaly (excess growth hormone). With this disease, all other lung volumes remain normal. The reasons for a decrease in FVC may be:
  • lung pathology (removal of part of the lung, atelectasis (collapsed lung), fibrosis, heart failure, etc.);
  • pathology of the pleura (pleurisy, pleural tumors, etc.);
  • downsizing chest;
  • pathology of the respiratory muscles.
• Forced expiratory volume in the first second (FEV1) is the portion of FVC that is recorded during the first second of forced expiration. FEV1 decreases in restrictive and obstructive diseases bronchopulmonary system. Restrictive disorders are conditions that are accompanied by a decrease in volume lung tissue. Obstructive disorders are conditions that reduce the patency of the airways. To distinguish between these types of violations, it is necessary to know the values ​​of the Tiffno index.
• Tiffno index (FEV1/FVC). For obstructive disorders this indicator always reduced, with restrictive ones it is either normal or even increased.



Decoding the results

If the patient experiences an increase or normal values FVC, but a decrease in FEV1 and Tiffno index, then they speak of obstructive disorders. If FVC and FEV1 are reduced, and the Tiffno index is normal or increased, then this indicates restrictive disorders. And if all indicators are reduced (FVC, FEV1, Tiffno index), then conclusions are made about mixed type FV violations.

Options for conclusions based on spirometry results are presented in the table.

Variant of violations	FVC	FEV1	Tiffno index
Obstructive disorders	norm/	↓	↓
Restrictive violations	↓	↓	norm/
Mixed violations	↓	↓	↓

It should be noted that parameters indicating pulmonary restriction may deceive the physician. Often restrictive disorders are recorded where they do not actually exist (false-positive result). For accurate diagnosis pulmonary restriction using a method called body plethysmography.

The degree of obstructive disorders is determined by the values ​​of FEV1 and Tiffno index. Algorithm for establishing degree bronchial obstruction presented in the table.

Bronchodilation test

If an obstructive type of respiratory function disorder is detected in a patient, it is necessary to additionally conduct a test with a bronchodilator to determine the reversibility of obstruction (impaired patency) of the bronchi.

A bronchodilator test involves inhaling a bronchodilator (a substance that dilates the bronchi) after spirometry has been performed. Then through certain time(the exact time depends on the bronchodilator used) spirometry is performed again and the indicators of the first and second studies are compared. Obstruction is reversible if the increase in FEV1 in the second study is 12% or more. If this indicator is lower, then a conclusion is made about irreversible obstruction. Reversible bronchial obstruction is most often observed in bronchial asthma, irreversible - in chronic obstructive pulmonary disease (COPD).

Bronchophonography (BFG) is used for children under 5 years of age. It does not consist of recording tidal volumes, but of recording breathing sounds. BFG is based on the analysis of respiratory sounds in different sound ranges: low-frequency (200 – 1200 Hz), mid-frequency (1200 – 5000 Hz), high-frequency (5000 – 12600 Hz). For each range, the acoustic component of work of breathing (ACWP) is calculated. It represents a final characteristic proportional to physical work lungs, spent on the act of breathing. ACRD is expressed in microjoules (µJ). The most revealing is the high-frequency range, since significant changes ACRD, indicating the presence of bronchial obstruction, is detected precisely in it. This method is carried out only with quiet breathing. Carrying out BFG at deep breathing makes the survey results unreliable. It should be noted that BPG is a new diagnostic method, so its use in the clinic is limited.

Conclusion

Thus, spirometry is an important method for diagnosing diseases of the respiratory system, monitoring their treatment and determining the prognosis for the life and health of the patient.

In some cases, after implementation this method should be carried out additional procedures. Therefore, the doctor may prescribe, for example, bronchodilator testing.

Other methods do not have as much wide application. The reason for this is that their use is still poorly understood in practice.

Diagnostics

High precision equipment
Modern research methods

Pulmonary function test

Prices for Pulmonary Function Testing

The study of external respiration is carried out using three methods: Spirography, Bodyplethysmography, Diffusion capacity of the lungs.

Spirography– basic examination of external respiration function. As a result of the study, they get an idea of ​​the presence or absence of violations bronchial obstruction. The latter arise as a result inflammatory processes, bronchospasm and other reasons. Spirography allows you to determine how pronounced changes in bronchial patency are, at what level the bronchial tree is affected, how pronounced pathological process. Such data is necessary for the diagnosis of bronchial asthma, chronic obstructive pulmonary disease and some other pathological processes. Spirography is performed to select therapy, control treatment, select for spa treatment, definitions of temporary and permanent disability.

In order to determine how reversible the pathological process is, to select treatment, functional tests. In this case, a spirogram is recorded, then the patient inhales (inhales) a medicine that dilates the bronchi. After this, the spirogram is recorded again. Data mapping before application medicine and obtained after its use, allows us to conclude that the pathological process is reversible.

Spirography is often performed healthy people. This is necessary when carrying out professional selection, for planning and performing training sessions that require stress on the respiratory system, confirming the fact of health, etc.

Spirography allows you to obtain valuable information about the state of the respiratory system. Often, spirography data needs to be confirmed by other methods, or to clarify the nature of the changes, to identify or refute the assumption that lung tissue is involved in the pathological process, to detail the state of metabolism in the lungs, etc. In all these and other cases, they resort to body plethysmography and carry out study of the diffusion capacity of the lungs.

Body plethysmography – if necessary, performed after basic research- spirography. The method accurately determines the parameters of external respiration, which cannot be obtained by spirography alone. These parameters include the determination of all lung volumes, capacities, including total capacity lungs.

A study of the diffusion capacity of the lungs is performed after spirography and body plethysmography to diagnose pulmonary emphysema (increased airiness of the lung tissue) or fibrosis (thickening of the lung tissue due to various diseases - bronchopulmonary, rheumatic, etc.). In the lungs there is an exchange of gases between the internal and external environment body. The entry of oxygen into the blood and the removal of carbon dioxide is carried out by diffusion - the penetration of gases through the walls of capillaries and alveoli. A conclusion about how efficiently gas exchange occurs can be made from the results of a study of the diffusion capacity of the lungs.

Why should it be done in our clinic?

Often, the results of spirography require clarification or detail. The Federal Scientific and Clinical Center of FMBA of Russia has special devices. These devices allow, if necessary, to carry out additional research and clarify the results of spirography.

The spirographs that our clinic has are modern and allow short time obtain many parameters to assess the state of the external respiration system.

All studies of external respiration function are performed on a multifunctional expert-class installation Master Screen Body Erich-Jäger (Germany).

Indications

Spirography is performed to establish the fact of health; establishing and clarifying the diagnosis (bronchitis, pneumonia, bronchial asthma, chronic obstructive pulmonary disease); preparation for surgical intervention; selection of treatment and monitoring of treatment; assessing the patient's condition; clarifying the causes and predicting the timing of temporary disability and in many other cases.

Contraindications

Early (up to 24 hours) postoperative period. Contraindications are determined by the attending physician.

Methodology

The subject performs various breathing maneuvers(calm breathing, deep inhale and exhale), following the instructions nurse. All maneuvers must be performed carefully, with the required degree of inhalation and exhalation.

Preparation

The attending physician may discontinue or limit the intake of certain medications (inhaled, tablet, injected). Before the study (at least 2 hours before) stop smoking. Spirography is best performed before breakfast, or 2–3 hours after a light breakfast. It is advisable to be at rest before the study.

FVD is a function of external respiration. Thanks to the FVD examination, the doctor can find out whether the patient’s lungs are healthy.

FVD with salbutamol: examination features, preparation, technique.

To understand whether there are any abnormalities in the functioning of the respiratory system or not, a test with Salbutamol is used. Salbutamol is a drug that dilates the bronchi.

Preparation

The details of the preparation are told by the doctor himself, based on the patient’s case. But despite this, there are main aspects of preparation:

1. The FVD session can begin only after the patient sits in a free, relaxed position, in a well-ventilated area with normal temperature(not exceeding +20 degrees Celsius).
2. The patient should rest for about thirty minutes before the examination.
3. The day before the examination you should not smoke or drink alcohol. Also, you should not wear clothes that compress the chest and prevent normal breathing.

If you follow all the rules in preparing for a physical examination, the examination results are guaranteed to be reliable.

Technique

In order to conduct a physical function test, you need a device called a spirometer. The doctor who prepared the spirometer puts a mouthpiece on it and measures the readings. In addition, performing a respiratory examination includes placing a clamp on the patient's nose and inserting a tube into the patient's mouth.

Sequence of examination

• The patient needs to stand or sit.
• A clamp is installed to prevent air from entering the patient's nose.
• A special tube is inserted into the patient's mouth.

Once the patient is ready for the examination, the doctor must give the patient instructions that he must follow. The patient is advised to take a strong breath, and then a long and equally strong exhalation.

You can see how the spirometer works in the video at the link.

FVD: research methods

The study of external respiration functions (ERF) contains the following techniques:

1. spirography— determines changes in indicators in air volumes;
2. peak flowmetry- determines the speed at which a person exhales.

A little about our breathing

Breathing is physiological process, which ensures normal metabolism, receiving oxygen from the environment and releasing it into environment carbon dioxide.

In case of disturbances in the functioning of the respiratory organs, studies of the ventilation function of the lungs are carried out.

1. FVC (forced vital capacity of the lungs)- this is the amount of air exhaled with intensification after a strong inhalation.
2. Vital capacity (vital capacity of the lungs)- this is the most large number the volume of air exhaled after a forceful inhalation.

Study of external respiration functions

Since in last days There is an increase in bronchological diseases, and a study of respiratory function becomes necessary. To identify any pulmonary diseases or disturbances in the functioning of the pulmonary system, a pulmonary function test is used.

Indications and contraindications

The examination cannot be carried out in the following cases:

• heart failure;
• acute infectious diseases;
• high blood pressure;
• severe angina.

Also, the study is contraindicated for children and people with mental disorders who will not be able to follow the doctor's instructions.

Indications for the study:

• asthma;
• bronchitis;
• silicosis;
• pneumonia and others.

Blood gas studies

Blood is mobile connective tissue.

Study gas composition studies blood arterial blood patient.

Blood for research is taken from the brachial, radial or femoral artery.

Components of blood that maintain the body's hydrogen level in in good condition called pH. Normal: 7.30 - 7.49.

Exceeding the normal threshold may result in serious illnesses or even fatal outcome. A decrease indicates that the patient has developed pathological processes.

Many important processes, such as biosynthesis, stimulation of cell fermentation, muscle and nerve transmission, depend on the state of the human blood.

Changes in blood gas composition may be metabolic or respiratory. Respiratory depends on normal level carbon dioxide, and metabolic from the reaction of changing the content of sodium bicarbonate in the cutting fluid.

FVD study: spirography, provocation test with methancholine, body plethysmography

Spirography is a procedure that helps identify any diseases of the respiratory system in early stages

With the help of spirography, you can find out if there are any disturbances in the functioning of the respiratory system.

Based on air volume indicators, the respiratory function is determined.

The examination is carried out using a spirometer. To study FVD using spirography, a clamp is placed on the patient's nose to prevent air from entering the nose, and a special tube is placed in the mouth.

The patient needs to exhale into the tube of the device.

The spirometer contains electronic sensors that record the volume and speed of air exhaled.

A study of the function of the respiratory system using spirography can be seen below:

Provocative test with methancholine

It often happens that the doctor cannot say for sure whether the patient has asthma or not. In order to accurately find out the presence or absence of asthma, you need to use a provocative test with methancholine.

This type of spirometry reveals readiness for bronchospasm, hyperactivity and asthma. Only through this type of spirometry can we say for sure whether a person has asthma or not.

With this test you can find out the presence of any bronchial asthma.

Bodyplethysmography

Body plethysmography is similar in many ways to conventional spirometry, but body plethysmography can provide more information. It determines all lung volumes.

The main aspects of undergoing body plethysmography:

• The patient needs to sit in a special booth, which is equipped with a pneumotapograph.
• During body plethysmography, the patient needs to breathe through a tube and follow all the doctor’s instructions.
• Any vibrations of the chest during body plethysmography are recorded.
• After this, you can immediately receive the results of the examination.

You can learn more about body plethysmography from the educational video

Study of the diffusion features of the lungs

The diffusion test evaluates the lungs' ability to deliver gas to red blood cells. This test requires expensive equipment and highly qualified doctors.

Aspects of preparation for the study of respiratory function: spirometry and body plethysmography

The day before the FVD, you should not smoke, eat heavily, or take bronchodilators.

What is spirometry and how is it performed?

Spirometry is used to determine lung parameters. A spirometric study identifies respiratory diseases and determines the severity of the pathology.

Preparing for spirometry

To ensure accurate spirometry results, you must:

• The day before the test, do not take medications that have an effect on respiratory processes.
• Before starting the session, do not drink strong tea or coffee. Do not use tobacco.
• The day before the procedure, do not wear clothing that restricts breathing.
• Before starting the session, you need to rest for about thirty minutes.

Sequence of spirometry

• The patient needs to sit or lie down.
• The doctor needs to apply a clamp to the patient's nose.
• And then insert the tube into your mouth.
• After the doctor’s command, the patient needs to take a strong breath, and then exhale strong and long.

Indications for spirometry

If the respiratory system malfunctions, lung function decreases. Spirometry helps identify diseases.

Indications:

• allergy;
• poor gas exchange;
• respiratory diseases;
• physical condition assessment;
• readiness for surgical intervention;
• detection of chronic obstructive pulmonary disease (COPD).

Spirometry norm indicators. Table.

What is FVD research? Does it hurt?

A respiratory function test is a check of the condition of the lungs and identification of diseases of the respiratory system. FVD research helps to identify diseases in initial stages and diagnosing their treatment.

FVD examination can be carried out in three ways:

• spirography;
• peak flowmetry;
• pneumotachometry.

Is it painful to get tested?

An FVD study does not hurt at all. All the patient needs to do is inhale and exhale into the tube at the doctor’s command.

FVD research in Moscow

The study of respiratory function makes it possible to identify lung diseases in the initial stages and diagnose their treatment. Since FVD research contains a lot various methods, then the prices will be different depending on the method, the equipment used, and the medications used.

The most inexpensive type of diagnostics is pneumotachography. On average, the procedure can cost about 500 rubles.

A study of respiratory function using spirography costs an average of 800 rubles. Below is a list of clinics in Moscow where you can undergo spirography:

Spirometry - study of respiratory function

Spirometry is a procedure that detects various diseases respiratory system in the early stages. In some cases, spirometry may be prescribed to teach proper breathing.

Indications for spirometry

• chronic cough or shortness of breath;
• allergy;
• violation of gas exchange;
• respiratory diseases;
• physical condition assessment;
• preparation for surgical intervention;
• detection of chronic obstructive pulmonary disease.

Aspects of preparation for spirometry.

In order to receive accurate results Spirometry requires:

• the day before the examination, do not take medications that have any effect on the respiratory processes and respiratory organs;
• three to five hours before the examination you should not drink strong tea and coffee;
• three to five hours before the test, do not smoke;
• the day before the examination, do not wear clothes that interfere with breathing and compress the chest.

Algorithm for spirometry

• the patient must stand or take a sitting position;
• a clip is placed on the patient’s nose;
• a special tube is inserted into the patient’s mouth;
• as directed by the doctor, the patient should take a deep breath, and then exhale forcefully and for a long time.

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