DOCSLIB.ORG

Monitoring Oxygenation Brandon Wahler, DVM, MS, Practice Limited to Anesthesia

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Monitoring Oxygenation Brandon Wahler, DVM, MS, Practice Limited to Anesthesia Just Keep Breathin’ and Breathin’ and Breathin’: Respiratory Monitors – Monitoring Oxygenation Brandon Wahler, DVM, MS, Practice Limited to Anesthesia Copyright © 2020 Care Center. All rights reserved. Goals Describe the difference Describe the oxyhemoglobin between oxygenation and Describe the way a pulse dissociation curve and factors ventilation and how we can oximeter works that will influence it monitor each What literature is present Outside of SpO values, what about the use of pulse 2 What factors may cause other information can we oximeters in veterinary abnormal pulse oximeter gather from the pulse medicine, and what role readings? oximeter? should the pulse oximeter play in our evaluation of a patient? Copyright © 2020 Care Center. All rights reserved. Take My Breath Away… • Remember that while respiration is technically just breathing in and out… http://hyperphysics.phy-astr.gsu.edu/hbase/Kinetic/henry.html http://www.chemistry.wustl.edu/~edudev/LabTutorials/CourseTutorials/Tutorials/Hemoglobin/conformation.htm https://www.ck12.org/book/skills-for-a-healthy-you/section/3.1/ http://people.eku.edu/ritchisong/301notes6.htm https://www.researchgate.net/figure/Schematic-presentation-of-tissue-oxygen-metabolism-at-the-cellular-and-intramitochondrial_fig4_51460198 Copyright © 2020 Care Center. All rights reserved. Ventilation vs. Oxygenation • Must be specific when describing the problems the patient is having! • Is the problem with Oxygenation (O2 problems that are measured by pulse oximetry or an arterial blood gas) or is the problem with Ventilation (CO2 problems measured by ETCO2/Capnography and arterial or venous blood gas measurements)? • These problems are oftentimes influenced by one another, but are independent issues • You may have problems that are deal with the respiratory system that are not necessarily issues with either (tachypnea, bradypnea, etc.) Copyright © 2020 Care Center. All rights reserved. Role of Oxygen in the Body The major player! Needs the NADH Produces H2O and CO2 https://quizlet.com/271984388/cellular-respiration-diagram/ Two part cycle – Generates a tiny amount of energy (ATP) Copyright © 2020 Care Center. All rights reserved. Anaerobic Metabolism Minimal generation of ATP This is the reason why lactate is Produces lactic acid measured to look at profusion – which must be cleared inadequate oxygen delivery to tissues https://myheart.net/lactic-acid-2/how-is-lactic-acid-produced/ Copyright © 2020 Care Center. All rights reserved. Hemoglobin • How do we get oxygen to the tissues? 4 heme Each RBC can contain molecules = 4 up to 300 million oxygen hemoglobin molecules that molecules and can be bound therefore bind 1.2 billion oxygen molecules https://openstax.org/books/anatomy-and-physiology/pages/18-3-erythrocytes Copyright © 2020 Care Center. All rights reserved. Carrying Capacity for Oxygen The amount of oxygen that can be carried by hemoglobin is much greater than what is dissolved in blood; this is why http://rc.rcjournal.com/content/62/6/645 anemia is a big deal Copyright © 2020 Care Center. All rights reserved. Can You Keep Up? SaO2 = Saturated percentage of hemoglobin in the arterial blood Challenging to Challenging to measure and prove; blood requires a pressure can be centrally used as an indirect placed measurement catheter (central line) Challenging to prove, requires samples before and after tissue; increased levels can be indicative of shock http://www.learnpicu.com/respiratory/oxygenation-oxygen-transport Copyright © 2020 Care Center. All rights reserved. Measuring FiO2 • The first step is understanding how much oxygen we are breathing in • Normally around 21% (0.21) oxygen in atmospheric air (the majority is nitrogen) • Under anesthesia or in cases where supplemental oxygen is being supplied this is oftentimes higher: 30-100% • FiO2 can be measured with different sensors • Oftentimes are stand-alone sensors to measure supplemental oxygen % • Not normally measured in veterinary anesthesia in general practice (assumed to be 100%) • Required in human medicine • Can be useful for detecting leaks and hypoventilation Copyright © 2020 Care Center. All rights reserved. Measuring Oxygen to the Tissues • We can indirectly measure this with pulse oximetry • Measures SpO2 which is the hemoglobin saturation of pulsatile blood flow in peripheral tissues • Different from SaO2 (requires a special machine) • Assumed to be similar to SaO2 in healthy patients https://www.maximintegrated.com/en/appCopyright-notes/index.mvp/id/4671/ © 2020 Care Center. All rights reserved. How Does It Work? • Differential absorption between red and infrared spectrum • Deoxyhemoglobin absorbs more light in the red band than oxyhemoglobin • Oxyhemoglobin absorbs more light in the infrared spectrum than deoxyhemoglobin • The pulse oximeter computes the difference and presents the percentage of hemoglobin that is oxygenated based on an algorithm Copyright © 2020 Care Center. All rights reserved. The pulse oximeter pulses the LEDs (red and infrared) on and off hundreds of times per second which allows it to look at peaks and troughs. The trough represents light transmitted through the capillary beds and venous blood The peak represents the light as it travels through this tissue and arterial blood The sensor turns “off” to look for background light and subtracts this from the other measurements http://newblog.tunstallhealthcare.com.au/connected-health/what-is-a-pulse-oximeter/ Copyright © 2020 Care Center. All rights reserved. Types of Pulse Oximeters • Transmission Pulse Oximeters • Reflectance Pulse Oximeters • “Classic” pulse oximeters • Flat probes • Clamp onto tissue • Relies on light that is reflected due • Light is passed through tissues to differences in reflective indices • Common in veterinary medicine of tissue Copyright © 2020 Care Center. All rights reserved. Probe is connected to SpO2 values and pulse the console by a cable, rates are normally with most cables being averaged (arrhythmias specific to the console make them unreliable) (cannot interchange them) Pulse amplitude or plethysmograph should be evaluated to Most pulse oximeters determine accuracy provide an audible tone which changes with saturation and have built in alarms to determine Must make sure the low pulse rates, and probe is saturation levels appropriately sized, if too large then SpO2 is falsely high Pulse Oximeter Units Copyright © 2020 Care Center. All rights reserved. Benefits of Pulse Oximetry • Known to be accurate (highest accuracy between 80- 95%) • Accuracy does not change with time • Not impacted by anesthetic gases or vapors • Fast response times • Noninvasive • Continuous measurements • Measurement of peripheral pulse quality • Light weight and compact • User-friendly • Reusable, affordable https://getwellue.com/products/pediatric-finger-pulse-oximeterCopyright © 2020 Care Center. All rights reserved. Literature • Pulse oximeter was ranked first in this study to determine monitor detected incidents • Front-line monitor for endobronchial intubation • Good backup monitor for monitors that would normally be used to detect incidents (capnography, ECG, etc.) • Found to be useful in circuit leak or disconnection • Of 1256 general anesthesia incidents 82% would have been detected by pulse oximetry alone if they had been allowed to play out (60% before damage to organs) Copyright © 2020 Care Center. All rights reserved. Literature • Looked at pulse oximetry of transmittance and reflectance pulse oximeters in 10 anesthetized dogs who they made hypoxemic and hypotensive • Found to provide accurate SpO2 measurements over a large range of MAP. • The monitors overestimate SaO2 when arterial saturation <70% • This is a common issue in most pulse oximeters Copyright © 2020 Care Center. All rights reserved. Oxyhemoglobin Dissociation Curve • Hemoglobin must be able to load and unload oxygen • Predictable based on relationship between oxygen tension and oxygen binding • Allows us to use SpO2 to predict how much oxygen is present at the tissues • Hypoxemia PaO2<80mmHg • Severe Hypoxemia PaO2<60mmHg • Hyperoxemia PaO2>110mmHg Copyright © 2020 Care Center. All rights reserved. When Do Problems Occur? • Generally SpO2 values are between 97-100% • PaO2 = 85-110mmHg Critical area • Technical hypoxemia is around 95% • because things PaO2 = 80mmHg begin to trend • Problems begin around 90-93% SpO2 values down quickly, • PaO2 = 60mmHg oftentimes a • Remember pulse oximeters are programmed for delay between people reading and • AKA Dogs can have slightly lower pulse oximeter readings than people and have the same levels of oxygen, but large animals patient levels tend to be more hypoxemic at lower saturations • Critical point ~93% • Large changes with only minimal changes in saturation • Most accurate between 80-95% Copyright © 2020 Care Center. All rights reserved. Shifting Oxyhemoglobin Dissociation Curve ↑ C – carbon dioxide ↑ A – acidosis ↑ D – 2,3-DPG (anemia) ↑ E – Exercise ↑ T – Temperature ↑ S – Species Face Right More likely to offload oxygen Copyright © 2020 Care Center. All rights reserved. FiO2 and PaO2 • In general the partial pressure of oxygen in the blood should be approximately 5 times the concentration of oxygen you are breathing in PaO = 21% x 5 2 Room Air Easy, but not always PaO2 = 105mmHg realistic Or No good way to discern why things are wrong PaO2 = 100% x 5 Intubated on 100% Oxygen PaO2 = 500mmHg Copyright © 2020 Care Center. All rights reserved. • Other ways to determine if the amount of oxygen in the blood is considered
Load more

Recommended publications
  • Testing Regimes 3364-136-PF-01 Respiratory Care Approving Officer
    Name of Policy: Testing Regimes Policy Number: 3364-136-PF-01 Department: Respiratory Care Approving Officer: Associate VP Patient Care Services / Chief Nursing Officer Responsible Agent: Director, Respiratory Care Scope: Effective Date: June 1, 2020 The University of Toledo Medical Center Initial Effective Date: July 1, 1979 Respiratory Care Department New policy proposal X Minor/technical revision of existing policy Major revision of existing policy Reaffirmation of existing policy (A) Policy Statement Pulmonary function testing is to be ordered according to these regimes or as individual procedures. All tests may be ordered individually. (B) Purpose of Policy To standardize the ordering procedures for pulmonary function testing. (C) Procedure 1. Pulmonary Function Test I: a. Nitrogen washout test: Determination •Functional Residual Capacity (FRC) • Indirect calculation of Residual Volume (RV) • In conjunction with the Slow Vital Capacity, determination of all lung volumes. b. Carbon Monoxide single breath test: • Determination of diffusing capacity (DLCO-sb) c. Slow Vital Capacity: determination of • Slow Vital Capacity (SVC) • Expiratory Reserve Volume (ERV) • Inspiratory Capacity (IC) d. Flow/Volume Loop: determination of the mechanics of breathing: • Forced Vital Capacity (FVC). • Forced Expiratory Volume in one second (FEV-1) %FEV-1/FVC • Average Forced Expiratory Flow between 25% and 75% of vital capacity (FEF 25-75%) • Maximum Forced Expiratory Flow (FEF-max) • Forced Expiratory Flow at 25%, 50% and 75% of vital capacity (FEF 25%, FEF 50%, FEF 75%) • Forced Inspiratory Vital Capacity (FIVC) • Average Forced Inspiratory Flow between 25% and 75% of FIVC (FIF 25-75%), Forced Inspiratory Flow at 25%, 50% and 75% of FIVC (FIF 25%, FIF 50%, FIF 75%) • FIVC/FVC ratio Policy 3364-136-PF- 01 Testing Regimes Page 2 •FIF 50/FEF 50 ratio e.
    [Show full text]
  • Medicare National Coverage Determinations Manual, Part 1
    Medicare National Coverage Determinations Manual Chapter 1, Part 1 (Sections 10 – 80.12) Coverage Determinations Table of Contents (Rev. 10838, 06-08-21) Transmittals for Chapter 1, Part 1 Foreword - Purpose for National Coverage Determinations (NCD) Manual 10 - Anesthesia and Pain Management 10.1 - Use of Visual Tests Prior to and General Anesthesia During Cataract Surgery 10.2 - Transcutaneous Electrical Nerve Stimulation (TENS) for Acute Post- Operative Pain 10.3 - Inpatient Hospital Pain Rehabilitation Programs 10.4 - Outpatient Hospital Pain Rehabilitation Programs 10.5 - Autogenous Epidural Blood Graft 10.6 - Anesthesia in Cardiac Pacemaker Surgery 20 - Cardiovascular System 20.1 - Vertebral Artery Surgery 20.2 - Extracranial - Intracranial (EC-IC) Arterial Bypass Surgery 20.3 - Thoracic Duct Drainage (TDD) in Renal Transplants 20.4 – Implantable Cardioverter Defibrillators (ICDs) 20.5 - Extracorporeal Immunoadsorption (ECI) Using Protein A Columns 20.6 - Transmyocardial Revascularization (TMR) 20.7 - Percutaneous Transluminal Angioplasty (PTA) (Various Effective Dates Below) 20.8 - Cardiac Pacemakers (Various Effective Dates Below) 20.8.1 - Cardiac Pacemaker Evaluation Services 20.8.1.1 - Transtelephonic Monitoring of Cardiac Pacemakers 20.8.2 - Self-Contained Pacemaker Monitors 20.8.3 – Single Chamber and Dual Chamber Permanent Cardiac Pacemakers 20.8.4 Leadless Pacemakers 20.9 - Artificial Hearts And Related Devices – (Various Effective Dates Below) 20.9.1 - Ventricular Assist Devices (Various Effective Dates Below) 20.10 - Cardiac
    [Show full text]
  • Effect of Inspiratory Flow Rate on Bronchomotor Tone in Normal and Asthmatic Subjects
    Thorax: first published as 10.1136/thx.39.2.86 on 1 February 1984. Downloaded from Thorax 1984;39:86-92 Effect of inspiratory flow rate on bronchomotor tone in normal and asthmatic subjects W HIDA, M ARAI, C SHINDOH, Y-N LIU, H SASAKI, T TAKISHIMA From the First Department ofInternal Medicine, Tohoku University School of Medicine, Sendai, Japan ABSTRACT The effect of the inspiratory flow rate during deep inspiration on the regulation of bronchomotor tone was studied in nine normal and 22 asthmatic subjects. Changes in bronchial tone were assessed by respiratory resistance measured by an oscillation method. In normal subjects with bronchoconstriction induced by methacholine a rapid deep inspiration reduced respiratory resistance more than a slow deep inspiration. Asthmatic subjects with spontaneous airway narrowing showed an increase in respiratory resistance after deep inspiration that was greater after rapid than after slow deep inspiration. On the other hand, in asthmatics with methacholine induced bronchoconstriction, bronchodilatation occurred after deep inspiration and this was also greater after rapid than after slow deep inspiration. Lignocaine inhalation attenuated both bronchoconstriction and bronchodilatation induced by both slow and rapid deep inspiration. These results suggest that the effects of deep inspiration are mediated at least in part via receptors in the airways. It is suggested that in asthmatic patients with spontaneous broncho- constriction irritant receptor activity will be increased in proportion to the speed of inspiration. After methacholine induced bronchoconstriction stretch receptor activity is likely to behave in a similar fashion, leading to an opposite effect. http://thorax.bmj.com/ A deep inspiration has been reported to produce a carbachol induced bronchoconstriction, and they transient decrease in airway calibre in some asthma- suggested that this might have been due to greater tic subjects.' 2 In contrast, in the presence of phar- stimulation of stretch receptors at higher flows.
    [Show full text]
  • Although It Is Obvious That the Blood Flow Through the Pulmonary Artery Is
    PULMONARY CAPILLARY BLOOD FLOW IN MAN 1,2 BY G. DE J. LEE 8 AND A. B. DuBOIS (From the Department of Physiology and Pharmacology, Graduate School of Medicine, University of Pennsylvania, Philadelphia, Pa.) (Submitted for publication March 2, 1955; accepted May 11, 1955) Although it is obvious that the blood flow the response time was satisfactory up to a rate of 35 through the pulmonary artery is pulsatile, it is not cycles per second. The pressure between the plethysmo- graph and compensatory chamber could be equalized by a so certain that it remains so within the pulmonary valve, and the plethysmograph could be vented to the capillaries. On the contrary, the direct Fick exterior by a solenoid operated valve in the wall of the method for measuring cardiac output expresses chamber. mean flow per unit time, and calculation of pul- The subjects, who had been active in the laboratory, monary arteriolar resistance tacitly assumes the were permitted to sit for 5 to 15 minutes before entering the plethysmograph. During the test, they were re- existence of a non-pulsatile blood flow. Further- quired to breathe in a special way, and to turn valves; more, it is not known whether the rate of gas dif- they were by no means basal. The subject sat in the fusion from alveolus to capillary varies with the closed plethysmograph with two 5-liter bags and two phase of the cardiac cycle. sampling tubes. His electrocardiograph (lead CF.4) The present communication describes a method was recorded simultaneously with the plethysmograph pressure, using a second Brush D.C.
    [Show full text]
  • Whole-Body Plethysmography
    CHAPTER 2 Whole-body plethysmography M.D. Goldman*, H.J. Smith#, W.T. Ulmer} *David Geffen School of Medicine, University of California, Los Angeles, USA. #Research in Respiratory Diagnostics, Berlin, Germany. }Research in Lung Function, Bochum, Germany. Correspondence: M.D. Goldman, David Geffen School of Medicine, University of California, Los Angeles, USA. The word plethysmograph is derived from the Greek plethusmos (enlargement), and is related closely to plethus (fullness) and plethora (fullness). Indeed, the fundamental function of a whole-body plethysmograph is the measurement of intrathoracic gas volume (TGV) and volume change. Whole-body plethysmographs have been used to measure changes in lung volume over a range of volumes, from the scale of millilitres to litres. Early reports of whole-body plethysmography to determine thoracic gas volume (TGV) [1] and airway resistance (Raw) [2] measured volume changes of the order of millilitres, in terms of associated changes in plethysmograph and alveolar pressures (Pa), using the constant-volume variable-pressure plethysmograph. Changes in lung volume during compression and decompression of thoracic gas were measured while the subject breathed entirely within the plethysmograph. An alternative volume-displacement whole-body plethysmograph measured volume changes of the thorax directly, including both changes in volume of gas flowing into and out of the lung and simultaneous changes in compression and decompression of thoracic gas [3]. In contrast to the constant-volume plethysmograph of DuBois et al. [1], subjects breathed in and out across the wall of the volume-displacement plethysmograph developed by Mead [3]. The volume-displacement plethysmograph provided more ready assessment of changes in TGV during extended manoeuvres such as the vital capacity (VC).
    [Show full text]
  • Operator's Manual
    Operator’s Manual 774612C © 2002 SensorMedics® Corporation Printed in the United States of America ii Operator's Manual Vmax Copyright and Trademark Notices © 2002 SensorMedics Corporation This document is protected under Title 17 of the US Code and is the sole property of SensorMedics Corporation. No part of this document may be reproduced or stored in any electronic information retrieval system without the prior written consent of SensorMedics Corporation, except as specifically permitted under copyright laws of the United States. SensorMedics, the SensorMedics logo, Autobox, Vmax, Oxyshuttle, and MicroGard are registered trademarks of SensorMedics Corporation. FreeFlow is a trademark of SensorMedics Corporation. Microsoft, Windows, and MS-DOS are trademarks of Microsoft Corporation. Intel and Pentium are trademarks of Intel Corporation. Other brands and their products are trademarks of their respective holders and should be noted as such. 774612C Operator's Manual iii Vmax Company Information Manufacturers USA Distribution (Vmax, 2130, V6200, and V62J) SensorMedics Corporation 22705 Savi Ranch Parkway Yorba Linda, CA 92887–4645 Telephone: (1) (800) 231 2466 (1) (714) 283 2228 Fax: (1) (714) 283 8439 European Distribution (Vmax, V6200) SensorMedics Corporation 22705 Savi Ranch Parkway Yorba Linda, CA 92887–4645 Telephone: (1) (800) 231 2466 (1) (714) 283 2228 Fax: (1) (714) 283 8439 European Distribution (V62J) Erich Jaeger GmbH Leibnizstrasse 7 D-97204 Hoechberg Germany Telephone: (49) (0) 931 4972-0 Fax: (49) (0) 931 4972-46 Authorized European Representative SensorMedics BV Rembrandtlaan 1b 3723 BG Bilthoven The Netherlands Telephone: (31) (0) 2289711 Fax: (31) (0) 32286244 www.sensormedics.com 774612C iv Operator's Manual Vmax Declaration of Conformity 774612C Operator's Manual v Vmax Precautions • Caution: Federal law restricts this device to sale by, or on the order of, a physician.
    [Show full text]
  • Routine Pulmonary Function Test
    Routine Pulmonary Function Test What is a pulmonary function test? Pulmonary function testing measures how well you are breathing. There are different types of breathing tests that can be done during pulmonary function testing. They include spirometry, lung volumes and diffusing capacity. Spirometry can show how much air you can breathe in and out. It also shows how fast you can breathe in and out. Lung volumes can provide further information about how your lungs are functioning. Diffusing capacity can show how well your lungs move oxygen from the lungs to the blood. The results of pulmonary function testing can help your doctor find the best treatment plan for you. How do you get ready for the test? There are no medication holds for the following pulmonary function tests 1. Baseline only 2. Spirometry and DLCO 3. Post Rx only For pre and post pulmonary function testing Please follow these directions when getting ready for this test. These medicines will affect the results of some of these tests and need to be stopped before the testing is done. If the medicine is not stopped before the test we will not be able to complete the test. Stop these inhaled medicines for 24 hours before your appointment: Advair® (fluticasone and salmeterol) Symbicort® (budesonide and formaterol) Dulera® (mometasone and formoterol) Breo ((fluticasone and vilanterol) Arcapta (indacerterol) Serevent® (salmeterol) Foradil® (formoterol) Serevent® (salmeterol) Tudorza® (aclidinium) Brovana (arformoterol) Perforomist (formoterol) Spiriva (tiotropium)\ Striverdi® (olodatarol) Anora (umeclidinium and vianterol) Stop these inhaled medicines for 6 hours before your appointment: Atrovent® (Ipatroprium), Combivent®(albuterol and ipatropium) DuoNeb® (albuterol and ipatropium) Stop these inhaled medicines for 4-6 hours before your appointment: Proventil HFA®, Ventolin HFA® ProAir® (albuterol), Xopenex® (levalbuterol) Continue to take all your other medicine as you usually do.
    [Show full text]
  • Measurement of Tidal Volume During High Frequency Ventilation by Impedance Plethysmography
    003 1-3998/88/2303-0253$02.00/0 PEDIATRIC RESEARCH Vol. 23, No. 3, 1988 Copyright O 1988 International Pediatric Research Foundation, Inc. Printed in U.S.A. Measurement of Tidal Volume during High Frequency Ventilation by Impedance Plethysmography KENNETH L. SANDBERG, DANIEL P. LINDSTROM, ELIZABETH D. KRUEGER, HAKAN SUNDELL, AND ROBERT B. COTTON Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232 ABSTRACT. Electrical impedance plethysmography was unobtrusive, it would be well suited to meet the requirements of evaluated in lambs as a method of measuring tidal volume safe application in newborn infants. (VT). Over tidal volumes ranging from 15 to 414% of estimated dead space, and frequencies of 300 to 1000 breathslmin, correlation between VT measured by the METHODS impedance technique and VT measured by whole-body Four lambs weighing 4.0 to 10.2 kg were studied on 6 days plethysmography was 0.98. Above 600 breathdmin, the between 1 and 7 wk after birth. During each study session, the correlation between the two methods was 0.94. Independent lamb was sedated with chloralose, but spontaneous breathing calibration of the impedance technique using a pneumo- was not abolished. After placement of a cuffed endotracheal tube tachograph at conventional rates of ventilation yielded through the mouth, the lamb was placed in a pressure-compen- absolute values of VT which closely corresponded to values sated, integrated flow, whole-body plethysmograph having a obtained with the whole-body plethysmograph (slope = volume of 165 liters. The endotracheal tube extended through a 1.05, intercept = 1.4 ml, r = 0.99).
    [Show full text]
  • Pulmonary Function Analyzer UMDNS GMDN 13182 Analyzers, Physiologic, Respiratory Function 35282 Pulmonary Function Analysis System, Adult Mechanics, Adult
    Pulmonary function analyzer UMDNS GMDN 13182 Analyzers, Physiologic, Respiratory Function 35282 Pulmonary function analysis system, adult Mechanics, Adult Other common names: Respiratory function analyzers; respiratory function mechanics analyzers; Calculator, pulmonary function laboratory Health problem addressed Pulmonary function analyzers measure the performance of a patient’s respiratory system, especially for outpatient or presurgical screening. These systems measure the ventilation, diffusion, and distribution of gases in the lungs. They are used to help assess patients with conditions like chronic obstructive pulmonary disorder (COPD). Product description Pulmonary function analyzers are designed to assess the volume, airfl ow, and derived parameters through the respiratory tract of adults and older children. These devices typically include a spirometry instrument (e.g., pneumotachometer, bellows, rolling-seal-type spirometer), a computer, a gas analyzer, and an electronic unit with computerized capabilities and appropriate software. In addition to diagnostic spirometer measurements, they may measure parameters such as functional Use and maintenance residual capacity, diffusing capacity of the lungs for carbon User(s): Physicians, nurses, other medical staff monoxide, and airway resistance. The analyzers are intended Maintenance: Biomedical or clinical engineer/ to provide a baseline for ventilatory function as well as identify technician, medical staff, manufacturer/ respiratory impairments. Some systems include a total-body servicer plethysmograph for measuring lung volume and Raw. Training: Initial training by manufacturer, Core medical equipment - Information Principles of operation operator’s manuals, user’s guide Spirometry instruments measure the volume of gases exhaled by the patient (i.e., volume changes of the lungs) either by Environment of use volume displacement or fl ow sensing methods.
    [Show full text]
  • Invasive and Noninvasive Methods for Studying Pulmonary Function in Mice Thomas Glaab1, Christian Taube1, Armin Braun*2 and Wayne Mitzner3
    Respiratory Research BioMed Central Review Open Access Invasive and noninvasive methods for studying pulmonary function in mice Thomas Glaab1, Christian Taube1, Armin Braun*2 and Wayne Mitzner3 Address: 1Department of Pulmonary Medicine, III. Medical Clinic, Johannes Gutenberg-University, Mainz, Germany, 2Fraunhofer Institute of Toxicology and Experimental Medicine (ITEM), Hannover, Germany and 3Division of Physiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA Email: Thomas Glaab - [email protected]; Christian Taube - [email protected]; Armin Braun* - [email protected]; Wayne Mitzner - [email protected] * Corresponding author Published: 14 September 2007 Received: 12 April 2007 Accepted: 14 September 2007 Respiratory Research 2007, 8:63 doi:10.1186/1465-9921-8-63 This article is available from: http://respiratory-research.com/content/8/1/63 © 2007 Glaab et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The widespread use of genetically altered mouse models of experimental asthma has stimulated the development of lung function techniques in vivo to characterize the functional results of genetic manipulations. Here, we describe various classical and recent methods of measuring airway responsiveness in vivo including both invasive methodologies in anesthetized, intubated mice (repetitive/non-repetitive assessment of pulmonary resistance (RL) and dynamic compliance (Cdyn); measurement of low-frequency forced oscillations (LFOT)) and noninvasive technologies in conscious animals (head-out body plethysmography; barometric whole-body plethysmography).
    [Show full text]
  • Standardisation of the Measurement of Lung Volumes
    Eur Respir J 2005; 26: 511–522 DOI: 10.1183/09031936.05.00035005 CopyrightßERS Journals Ltd 2005 SERIES ‘‘ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING’’ Edited by V. Brusasco, R. Crapo and G. Viegi Number 3 in this Series Standardisation of the measurement of lung volumes J. Wanger, J.L. Clausen, A. Coates, O.F. Pedersen, V. Brusasco, F. Burgos, R. Casaburi, R. Crapo, P. Enright, C.P.M. van der Grinten, P. Gustafsson, J. Hankinson, R. Jensen, D. Johnson, N. MacIntyre, R. McKay, M.R. Miller, D. Navajas, R. Pellegrino and G. Viegi CONTENTS AFFILIATIONS Background and purpose .................................................... 512 For affiliations, please see Acknowledgements section Definitions and subdivisions of lung volume ...................................... 512 Patient preparation ......................................................... 512 CORRESPONDENCE Derivation of lung subdivisions ................................................ 512 V. Brusasco Measurement of FRC using body plethysmography ................................ 513 Internal Medicine University of Genoa Introduction and theory . 513 V.le Benedetto XV, 6 Equipment . 513 I-16132 Genova Measurement technique . 514 Italy Quality control . 514 Fax: 39 0103537690 E-mail: [email protected] Calculations . 515 Measurement of FRC using nitrogen washout..................................... 515 Received: Introduction and theory . 515 March 23 2005 Equipment . 515 Accepted after revision: April 05 2005 Measurement technique . 516 Quality control . 516 Calculations
    [Show full text]
  • Pulmonary Function Testing (PFT)
    Pulmonary Function Testing (PFT) What is done during the routine pulmonary function test? You will do a number of breathing tests repetitively depending on what tests are ordered. Spirometry can show how much air you can breathe in and out, and is also referred to as a Forced Vital Capacity or FVCs. It also shows how fast you can breathe in and out to complete maximum volume. This test is usually done before and after a bronchodilator medication is given to you. Lung volumes and airway resistance measurements can provide further information about how your lungs are functioning. Diffusing capacity can show how well your lungs move oxygen from the lungs to the blood. The results of pulmonary function testing can help your doctor find the best treatment plan for you. The technician will explain what you need to do during each test. A good effort during the testing is important to get good results. The technician will coach you during each test to help you give a good effort. You will be asked to sit in a booth while you are being tested. This booth is called a body box or plethysmograph. You will do different breathing techniques, blowing into a tube, while in the booth. Each breathing technique is often repeated to make sure the test is reliable. How long will the test take? A Complete Pulmonary Function Test (PFT complete – lung Vol + DLCO) often takes 1 ½ hours to complete. If just a PFT Pre & Post BD test is all that is ordered that could take about 30 to 45 minutes.
    [Show full text]