Bedside Pulmonary Function Test
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Chandan SardarBedside Pulmonary Function Test
Uploaded by
Chandan SardarBed side Pulmonary Function Tests
Pulmonary function tests have been used traditionally in the preoperative assessment before any
major surgery.
INDICATIONS
-To predict the presence of pulmonary dysfunction
-To know the functional nature of disease (obstructive or restrictive. )
-To assess the severity of disease
-To assess the progression of disease
-To assess the response to treatment
-To identify patients at increased risk of morbidity and mortality, undergoing pulmonary resection.
-To identify patients at perioperative risk of pulmonary complications
- Degree and severity of impairment
-Identify the site of airway obstruction
1. Sabrasez breath holding test:
Ask the patient to take a full but not too deep breath & hold it as long as possible.
>25 SEC.-NORMAL Cardiopulmonary Reserve
15-25 SEC- LIMITED CardioPulmonary Reserve
<15 SEC- VERY POOR CardioPulmonary Reserve (Contraindication for elective surgery)
25 - 30 SEC - 3500 ml VC
20 - 25 SEC - 3000 ml VC
15 - 20 SEC - 2500 ml VC
10 - 15 SEC - 2000 ml VC
5 - 10 SEC - 1500 ml VC
2. Single breath count: After deep breath, hold it and start counting till the next breath.
Normal- 30-40 COUNT
Indicates vital capacity
3. SNIDER’S MATCH BLOWING TEST:
Measures Maximum Breathing Capacity(MBC)
Should take 6 attempts Ask to blow a match stick from a distance of 6” (15 cms) with
Mouth wide open
Chin rested/supported
No pursed lips
No head movement
No air movement in the room
Mouth and match stick at the same level
Can not blow out a match
• MBC < 60 L/min
• FEV1 < 1.6L
Able to blow out a match
• MBC > 60 L/min
• FEV1 > 1.6L
• MODIFIED MATCH TEST of Olsen:
DISTANCE MBC
9” >150 L/MIN
6” > 60 L/MIN
3” > 40 L/MIN.
4. GREENE & BEROWITZ COUGH TEST:
DEEP BREATH F/BY COUGH
-ABILITY TO COUGH
-STRENGTH
-EFFECTIVENESS
INADEQUATE COUGH : FVC < 20 mL/Kg
FEV1 < 15 ml/Kg
PEFR < 200 L/min.
VC ~ 3 TIMES TV FOR EFFECTIVE COUGH.
A wet productive cough / self propagated paroxysms of coughing – patient susceptible
for Pulmonary Complication.
5. FORCED EXPIRATORY TIME:
After deep breath, exhale maximally and forcefully & keep stethoscope over trachea & listen.
Normal FET – 3 - 5 SEC
Obstructive Lung Disease - > 6 SEC
Restrictive Lung Disease - < 3 SEC
6. RESPIRATORY RATE
• Essential yet frequently undervalued component of PFT
• Imp. evaluator in weaning & extubation protocols
• Increase RR ‐ muscle fatigue ‐work load ‐ weaning fails
7. DE BONO’S WHISTLE BLOWING TEST:
Measures PEFR.
Patient blows down a wide bore tube at the end of which is a whistle, on the side is a hole with
adjustable knob.
As subject blows → whistle blows, leak hole is gradually increased till the intensity of whistle
disappears. At the last position at which the whistle can be blown , the PEFR can be read off the
scale.
8. Wright ‘s Respirometer : measures VT and minute volume
- Simple and rapid
- Instrument- compact, light and portable.
- Disadvantage: It under- reads at low flow rates and over-reads at high flow rates.
- Can be connected to endo tracheal tube or face mask
- Prior explanation to patient is needed.
Ideally done in sitting position.
MV- instrument record for 1 min and read directly
VT-calculated and dividing MV by counting Respiratory Rate.
Accurate measurement in the range of 3.7-20 L/min.(±10%)
USES:
1) Bedside PFT
2) ICU – Weaning Pts. from Ventilator.
9. MICROSPIROMETERS – MEASURE VC.
10. BED SIDE PULSE OXIMETRY
11. ABG.
