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Clinical Insights

Basic of Spirometry part 1 of 2

HISTORY OF SPIROMETRY
The first Spirometer was invented in 1846 by an English surgeon (and violinist!) John Hutchinson who presented his first device to the “Royal Physiological Society” in London. Hutchinson showed a direct relationship between a reduction in this parameter and the life expectancy of the individual, and defined the term Vital capacity (VC).

THE BELL SPIROMETER
Hutchinson presented a study carried out on 2,130 subjects, and showed that the VC was directly correlated to height and to age, both in men and in women. The spirometer used was a water or bell spirometer.

FEV1 – an introduction
Another surgeon Edward Gaenslar introduced the concept of FEV1 = Forced expired volume in the 1st second This reinforced the earlier discovery of Hutchinson and led to the development of the modern concept of FLOW (air velocity)

What is Spirometry?
What does Spirometry measure?
HOW MUCH AIR?
(Volume…FVC…measured in “L”)
HOW FAST IT IS EXHALED (FLOW…measured in “l/sec or l/min)

WHY DO SPIROMETRY?
Spirometry is the most basic, objective Pulmonary Function test to asses lung health status.
It establishes baseline measurement of patient‘s lung function.
It helps to identify if they have narrow airways or reduced capacity.
It determines treatment regimen; Bronchodilators or Nebulizer.

Spriometry is required to make a definitive diagnosis of both Asthma and COPD and it can be done bedside, in a PFT lab or a physicians office.

As part of a general patient’s health program.
As part of pre-employment screening.
As part of a regular check for employees working in high risk environments for lung disease.
As part of yearly evaluations of smokers over 40.
As part of a smoking cessation program.
As part of a bedside screening program
Is there a history of dyspnea (shortness of breath) on exertion or at rest?
Is there a history of chronic cough or sputum production?
Is there a history of wheezing or chest tightness?
Is there a history of frequent colds or runny nose?
Is there an occupational exposure to inhaled dusts or chemicals?
As follow-up visits for patients with lung disease.
As management for all patients taking bronchodilators.
To evaluate he effects of air pollution.
As early detection of congestive heart failure

Spirometry can help to identify lung diseases in their early stages 10 years, before the onset of symptoms, therefore facilitating an early course of treatment and potentially modifying the course of the disease. Recent studies on ASYMPTOMATIC PATIENTS (USA-2000) have shown that 7% had significant respiratory pathologies.

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