The most secure method for determining external respiratory functions is spirometry. It is based on the evaluation of breathing when measuring the main indicators of lungs: the life capacity and the frequency of inhalation and exhalation. The study is performed according to the instructions of a specialist in the field of functional diagnostics. You can make it in medical centers or clinics. In Moscow, the price of the service is from 1500 to 3000 rubles.

What is spirometry, is it really needed?

Study of the functions of the lungs should be performed at:

• symptoms of respiratory diseases;
• determining the sources of incorrect gas exchange;
• assessing the risk of used therapy for the patient;
• determining the physical condition;
• determining the level of bronchial obstruction, especially when COPD (chronic obstructive lung disease).

The results will indicate the correctness of the choice of the tactics of the treatment of pathologies of external respiratory functions. Made at the initial stages of spirometry increases the chances of the patient for recovery. Nelfish this method It will be for assessing the health of athletes and smokers.

Spirometry at bronchial asthma discovers signs of the disease, and for asthma patients - controls the effectiveness of treatment. A timely diagnostics of COPD will begin to begin treatment and avoid death. For the correct assessment of pathologies, in addition to clinical trials, the doctor should examine the patient and listen to his complaints.

Preparation for spirometry

Spirometry of the lungs are carried out in the morning on an empty stomach, a non-living breakfast is allowed 2 hours before the procedure. For the accuracy of the test, it is worth sticking to the basic rules:

• abandon smoking in a few hours;
• replace morning coffee on a healthier drink, such as juice;
• in some cases, the attending physician may cancel the use of medicines for several hours to the patient;
• select loose clothes that will be most convenient as possible.

20 minutes before the procedure, the patient will offer to relax and restore respiratory functions while at rest. The doctor must figure out whether there are no diseases that may affect the study of lung functions (pneumothorax or myocardial infarction on the first two weeks of development). People after the eye surgery or during the hemoplinary, this test must be carefully followed by the main recommendations of the specialist.

How is Spirometry?

The history of the technique begins in Ancient Rome: Greek Doctor Galen explored the volumes of inhaled and exhaled air with simple bubbles. Today is popular modern method Studies of external respiratory functions.

Computer spirometry is a sterile procedure that starts with the mounting of a disposable mouthpiece to the device. After the patient sat down, he is asked to trust his mouth to a one-time mouthpiece and follow the recommendations of the doctor: exhale on the maximum breath with or without effort, alternating with a calm exhale. If the exhale at the maximum speed is carried out within 15 seconds, it is worth talking about the pathologies of the lungs. All indicators are fixed and performed 3 times. Then choose the most successful results, with the help of which the pulmonologist makes a diagnosis or adjust the therapy of the existing disease. The spirometer decrypts data and automatically calculates the performance of respiratory functions.

Spirometry in children

Children undergo a diagnostic study recommended from the five-year-old age. It is believed that the child of more primary age cannot carry out all the maneuvers of forced air. For up to 9 years old, experts with experience and skills of communicating with kids should be engaged.

The algorithm for conducting spirometry in children does not differ from that in an adult patient, and the results of the surveys are different. The situation, like the attitude towards the child, should be friendly; The presence of toys in the laboratory will help to adapt to the child faster. A specialist who explores the lungs in children must control the correctness of the procedure and try to eliminate possible air leaks on time test.

The feasibility of learning the lungs with the bronchodiolitic

For effective pathological detection, spirometry with a broncholitic is carried out. The study with the bronchodilitics will help to detect spasm in bronchi in time and check the effectiveness of the use of bronchus-seating drugs. The procedure is based on an evaluation of external respiratory functions for 20 minutes. With a cough version of asthma, computer spirometry indicators remain normally. In this case, the patient will be offered to study ventilation properties with a broncholitic.

Interpretation of the main indicators

Spirometry indicators are the main sources of information in medicine during diseases of the lungs, the norm of spirometry is the average values \u200b\u200bof the results of the study of people with healthy authorities. They are directly dependent on the physiological standards of the patient (weight, growth, gender) and lifestyle. The unit of the spirometry indicator is calculated in percentage and indicates the compliance of the body under study with respect to normal spirometry indicators. The diagnosis is carried out according to the values \u200b\u200bunder study, and their subsequent interpretation in the form of a graph is called spirography.

For patients, spirometry differs from spirography with a high-quality image: in the form of quantities or graphs, respectively. We present the interpretation of the indicators:

1. Up to - characterizes the volume of respiratory air. In a healthy person, the air volume that entered the light in one breath, when performing a procedure in a calm state, the results are 500 to 800 ml.
2. Jack - qualitatively determines the vital capacity of the lungs. Under this term in medicine, the amount of air is understood when the patient exhale. This test is performed on the maximum breath and exhalation. Jack is the main characteristic to control the diseases of the lungs and the effectiveness of the applied therapy. The norm of the jam is expressed in the percentage of the test conducted from the physical parameters of the patient.
3. Fire - forced desire. The study is performed by S. maximum power In the breath-exhale. Fire1 shows the passability of air masses in the trachea and bronchi. Normal forced exhalation occurs in 1.5 - 2.5 seconds, which is 90% in relation to the jam.
4. OFV1 defines exhalation volumes for one second with maximum acceleration. Its norm is 75% of the temper.
5. The Tiffno index indicates the ratio of the 4th indicator relative to the 5th. Norma OVF1 / Ferzha is from 70%.
6. The average bulk speed indicator is used to detect obstruction on early stages. Minimum results - 25%.
7. The peak value of the maximum exhalation in the norm should be at least 25%.

The doctor analyzes research results depending on the determining factors (by age, sex and physical patient skills). To calculate the proper values, it compares the values \u200b\u200bobtained with their norms, borders, gradations and relative degree of deviation. The number of tests is displayed on the spirometer, a specialist is engaged in deciphering spirometry.

The interpretation of the values \u200b\u200bobtained is drawn up in the form of a graph of deviations of light functions from the norm of spirometry. The standards of spirometry take the testimony of ventilation properties in a healthy person. The detected deviations of the lungs are interpreted in three stages: moderate, significant, sharp.

The correct decoding of spirometry will help determine the disease at the initial stage, for more severe diseases, for example, when COPDs, additionally investigate the grinding indicator. With the deviations of the ventilation properties, the grinder is less than 50%.

Contraindications for research

To carry out a qualitative assessment of the ventilation properties of the lungs, the study is necessary in three stages. Some patients during spirometry complain of fatigue or dizziness, most often these phenomena take place in a few minutes. The development of other complaints is unlikely and depends on the history of the patient.

During testing, some indicators require a patient with an inhalation with a maximum force, which causes a load on the chest, followed by an increase in pressure: intra-abdominal and intracranial. Due to the possible deterioration of health, spirometry has contraindications for patients:

• after operations in front of the eyes, abdomen and chest, the examination is only after two months from the moment of operational intervention;
• in the presence of an existing myocardial infarction or stroke during the first month;
• during pneumothorax;
• with light bleeding;
• with all sorts of exchange disorders: varicose veins and high blood coagulation;
• with uncontrollable increased pressure;
• having mental disorders;
• by age: it is not recommended to perform children under 5 years and patients after 75 years.

Spirometry is carried out by the appointment of a doctor who must take into account the history of the patient and the presence of contraindications. Sometimes with their presence, the specialist still prescribes the study of the function of external respiration. In this case, it is necessary to be prepared for urgent assistance to the subject.

After completion of the procedure, the results are issued to the patient for half an hour. Smoking people must examine the functions of the lungs every year, for the rest - spirometry is a way to diagnose respiratory functions.

Analysis of spirometry - This is a study of the respiratory function, in which experts determine its volume and speed. Such a study is necessary for diagnosing diseases, one way or another associated with impaired function of the respiratory organs, or insufficient oxygen exchange in the body.

Types of spirometry

Today 4 types of spirometric samples are distinguished:

• functional samples in which special medicines are used - armored bronchospasm.
• trouble breathing test;
• sample of forced exhalation;
• sample maximum lung ventilation.

For samples, a special device is used - a spirometer that allows you to measure the volume of air that comes from the lungs. It is used for a comprehensive assessment of the condition of the respiratory system, which is a necessary step to determine and treat certain diseases.

Contraindications and goals of spirometry of the lungs

This method of examination does not have restrictions on age parameters and has no contraindications.

It is believed that spirometry should carry out all smokers, at least once a year to control the condition of the respiratory system and, if necessary, to detect a violation.

This method allows to detect obstructive lung diseases, as well as sarcoidosis.

Conducting spirometry

For the procedure, a spirometer is used, which graphically records the amount of inhaled and exhaled air. To preserve the sterility of the procedure, a disposable mouthpiece is allocated to the device.

At first, the patient is asked to take a deep breath and delay their breathing, after which you need to feel tightly to the mouthpiece, and then smoothly and calmly breathe the resulting air. In chronic lung diseases, this procedure can take 15 seconds. After the exhalation is completed, the patient is asked to take a deep breath, delay their breathing and with effort dramatically breathe air.

In the first case, calm breathing is measured, and in the second - the power of the exhalation.

For the accuracy of the data, this procedure is carried out three times and output an average indicator.

Deciphering spirometry

Spirometry has several indicators:

• Zan - Lung Life Capacity;
• Freak - with a forced exhalation, the difference between air volumes in the lungs at the beginning and end of the exhalation is calculated;
• OFV1 - the volume of exhalation in the first second;
• POS - the rate of exhalation;
• Mos is the speed of air traffic during the exhalation.

Norms of spirometry

For the installation parameter, the following indicators are defined, which are displayed in the percentage ratio:

Breathing deeply and expanding the lungs, born to light new life. With the last sigh, the trait of the person's stay on this land is supplied.

How often do we pay attention to your breath? Agree that only when we are experiencing some difficulties. The awareness of the vital importance of this process occurs when we cross through the threshold of the hospital, with plenty and hope for help.

Doctors, helping us in determining further steps, use all their medical instruments, in which in the first place, beyond any doubt, is a spirometry.

Spirometry - What is it?

Functional testing of the lungs, for which spirometry is carried out, is the central part of clinical medicine.

This type of study is intended to ensure the following tasks:

1. Diagnostics and assessment of gravity of lung disease.
2. Definition of persons potentially predisposed to pulmonary diseases.
3. An objective risk assessment before conducting surgical operations.
4. Determination of the effectiveness of the therapeutic measures aimed at the treatment of various pulmonary agers.
5. Drawing up an objective picture of disease flow based on the results obtained from various pulmonary tests.
6. Preparation of prolonging consequences during the course of the disease.
7. Training of patients with the method of proper breathing and various wellness exercises.

Circuit diagram of spirometer

Indications to Procedure

The following testimony exist for the survey:

1. Testing is necessary for adults and children who have a respiratory dysfunction.
2. In the preparatory period for invasive examination methods: the study of the arrogant biological material, bronchoscopy and other operational interventions.
3. Groups of patients, potentially predisposed to asthmatic diseases and tuberculosis. The latter refer to malicious smokers who must be examined at least once a year.
4. Patients who declared complaints relating to the respiratory system, as well as after x-ray, which revealed certain changes in the lungs.
5. Persons are actively or professionally engaged in sports, in order to study the influence of physical exertion on the functionality of the lungs.
6. Hypercapnia - gas exchange disorder, excessive carbon dioxide CO

Methods of research Functions of external respiratory

Testing, i.e., the study of the possibilities of external respiration involves the use of a whole toolkit that is in the arsenal of modern medicine.

The following techniques are applied to study the dysfunctions arising and preventing negative consequences:

1. Spirography - This method allows you to study the dynamics of changes in the function of an external respiratory contour with various respiratory stages and reflect this process in the graph.
2. - It explores the vital capacity of the lungs (jerking), with different cycles of the respiratory process.
3. Pneumothometry - The method allows you to fix the high-speed maximum inhalation of exhalation at forced loads.
4. Picoflorometry - This is the method of self-control of bronchi passability. Picofloumetre fixes the volume of air passing through bronchi, with a full deep exhale.
5. Functional tests (Barbecue and gene) is a method that allows us to conclude about the oxygen support of the body in breathing delay mode.

Video about three respiratory tests:

Modern toolkit of spirometry assesses not only the obvious functionality of the respiratory system, but also is able to open the development of nascent pathology.

For this, certain conditions are created. Such methods include spirography with bronchodiolitic or spirography with breakdown. Using Berodual, Salbutamol, Ventoline, this test allows you to study to spasm and after removing it and thereby detect hidden bronchospasm.

An example of a vital situation. Some readers, and such a lot, are interested in the question: how to deceive spirography? Here is one of the characteristic cases. Question of the reader: "I do not want to receive a" white ticket ", I want to go to the army. However, asthmatic bronchitis was diagnosed as a child, although the attacks were not long ago, 10 years ago. Tell me how to "get around" spirograph? " Experts advise - before examining the admission of Ventoline, but do not talk about it to anyone, take a ruined in the mouth and blow through all the power. This drug will remove spasms from the bronchi. As you understand, this is not a recommendation or advice, this example is just taken from life.

Attentive reader, noticing some similarity of the first two methods, can ask a completely informed question: how are spirometry and spirography differ?

Modern spirometer

Indeed, the difference is both fundamental. Spirometry is a method for determining the volume of lungs and high-speed respiratory system, while spiritography is directly tools, which allows you to build an alcohol - a graphic pattern of changes (dynamics) of the lungs with different loading modes of breathing.

The simplest spirographs, representing hermetic containers filled with oxygen, go into the past.

Today, in medicine to diagnose the functions of the lungs, such as the indication of their life capacity and exhalation volume, compact and extremely "smart" devices that called spirotest are used (see photo).

Spirography when writing on automated devices, using computers and modern software products - computer spirography, significantly simplifies the process, eliminating the human factor when deciphering, increases the objectivity and accuracy of the results.

Preparation

In preparation for spirometry, to obtain objective and most accurate data on the state of light and bronchi, the patient needs to perform a number of conditions:

1. The survey must be carried out in the morning hours, on an empty stomach, with a splintered intestine and bladder bubble, after a 20 minute sedative relaxation.
2. Before the test, it is forbidden to drink strong coffee, smoking and taking bronchillace preparations, such as:
   • combined preparations and beta-2 short-acting agonists - in 6 hours;
   • beta-2 long-acting agonists - for 12 hours;
   • prolonged theophyllins - in 24 hours.
3. In the course of the entire survey, the patient must be in a sitting position, keep the body exactly, without tension, clothing should not shove the chest and stomach.
4. Throughout the test, use the nose clamp and a special ruined, tightly pressed to all areas of the mouth, including lips.
5. If there are patients with dentures, they cannot be removed, for they serve as a kind of focusing for a ruined.
6. If necessary, the patient in practice shows the procedure for performing this study.

How is the test?

The process of research is a completely painless test, in which the patient does not feel absolutely no discomfort.

Algorithm Conducting spirometry:

1. Straightening the shoulders and unfolding the chest, the patient is sitting on the chair. It should save this position for the whole time.
2. The nose is clamped with a special overlay that does not allow air movement, except for the mouth.
3. The surveyed takes a special ruined in the mouth, which is connected to the registering device. Tightly wars his mouth and presses her lips.
4. At the command of the doctor, the subject makes the most deep breath, filling the air all the pulmonary space.
5. Further - long, as if "cleansing" strong exhalation.
6. After that, the repetition is a fast, forced deep breath and the same full exhalation.
7. For the maximum accurate averaged result, multiple measurements are used.

For a differentiated study in patients with asthma and COPD (chronic obstructive pulmonary disease) uses the "Spirometry with a reception of the broutine". It is differently called functional or provocative samples, during which the patient takes medicines that expand or narrow bronchi.

Normal indicators

Spirometry with all its apparent simplicity allows you to study the state of the lungs in many components and compare them with the norm. The table below contains the main indicators characterizing the operation of the respiratory system.

Table of normal spirometry indicators:

Parameters	Designation	Value	Norm for men	Norm for women	unit of measurement
Total (total) lung capacity	TLC	80% of TLC	7,0	6,2	l.
Life tank	VC.	80% of TLC	5,6	5,0	l.
Forced vitality	FVC.	80% of TLC	5,6	5,0	l.
Functional residual capacity	FRC	45% from TLC	3,2	2,8	l.
Residual volume	RV	20% of TLC	1,4	1,2	l.
Maximum expiratory respiratory strength	Vemax		10	10	l / S.
The value of the respiratory border (at a frequency of 1/30 minutes)			110	100	l / min
Resistance respiratory tract	R L.		0,13	0,13	kpa
The volume of forced exhalation - OFV1	Fev1		> 75	> 75	% from due *
Index Tiffno - FEV1 /	Fev1% T.		75–85	75–85	% from due
Peak bulk forced exhalation rate - pos	PEF		> 80	> 80	% from due
Maximum ventilation volume lungs - MVL	MVV.		> 80	> 80	% from due

Note. The term "due" is a completely official term that characterizes the respiratory rate of a healthy person. Synonym - "Normal".

Spirometry in children

Spirometry is a survey process passing under certain conditions. Small child They are simply not able to perform them. Therefore, the holding of the doctor's spirometry does not appoint children under five. After this age, this test can successfully hold only a qualified specialist who has communication skills with children and able to have them to themselves.

The algorithm for conducting this procedure is absolutely no different from the adult survey. It is simply the very furnishing for a child must be more comfortable, having and good-natured.

However, given the temperament and unforgettable children, the specialist should be extremely attentive in the correct observance of all components of the test, especially this applies to the fulfillment of inhalation and exhalation using a ruined and nasal clamp, in order to prevent possible air leakage.

Decoding results

Decoding of the lung alcohol is an equally responsible process than spirometry itself. Only an experienced specialist is able to identify respiratory disorders.

Pathology is divided into two types:

1. Restriction- Reduction of tensile pulmonary fabric or its volume. With this form of pathology, the rate of forced vital capacity is detected less than 80%.
2. Obstruction.This is a state at which spasm, the swelling of the mucous membrane or the accumulated sputum violate the natural loss of respiratory channels.

Each person has its own indicators, referred to as proper or normal. They are calculated by a doctor before testing and taken as the reference, with which the data obtained is compared. The result is considered normal if the result of the study is at least 80% of the due value.

The norm of the main spirometric results in children is the same as in adults, since the method of preliminary calculations of "proper" indicators is identical.

The basic diagnostically significant indicators include:

1. Fire or forced lung life capacity is the maximum air volume that the subject is capable of freeing from the lungs after a deep breath. Thus, the tensile tensile tensions occurs. The norm is frequent\u003e 80% of the proper.
2. OFV1 - the rate of forced exhalation for 1 second, it is\u003e 75%. This indicator giving objective assessment Air passing speeds refers to the diagnosis of bronchial channels and is the most informative in spirometry.
3. The Tiffno index - this parameter is calculated as the ratio of FEV1 to freak and varies from 75 to 85% of the due. It is the test Tiffno allows you to distinguish one pathology from another.

With age due to obstruction, the index value of Tiffno begins to decline, since the volume of the forced exhalation falls. When irreversible processes associated with the elasticity of the lungs begin, it is naturally changing the cluster.

In addition, other indicators are analyzed during the decryption:

1. Respiratory frequency (CH) - the number of respiratory movements in 60 seconds. For a healthy person, the norm is 16-17 sighs (exhale).
2. Respiratory volume (up) - air volume entering the lungs in one deep breath. This indicator has an extremely large variation of the values \u200b\u200bcharacterizing the norm: for men 300-1200 ml, for women 250-800 ml. It depends primarily on the physical dimensions of the subjects.

Contraindications for research

Spirometry requires patients with certain physical efforts, such as deep-tightening sigh, chest voltage and abdominal cavity. In some patients, this may cause a light dizziness, an increase in intracranial and intra-abdominal pressure.

In this regard, for this type of research, the medicine has introduced some limitations:

1. The ability to conduct a test not earlier than a two-month period after transferred surgical operations on the chest, eyes and stomach.
2. In stroke and myocardial infarction - no earlier than in a month.
3. Pneumothorax - accumulation of gas or air in the pleural area.
4. Lonantic bleeding.
5. Uncontrolled blood pressure changes.
6. Psyche disorder.
7. Age restrictions: children under five, adults after 75 years.
8. Pathology of metabolic processes: High blood coagulation and varicose veins.

Spirometry is a very effective tool that allows the most accurately and with great objectivity to conduct a study of external respiratory and diagnose on early stage The development of various pathologies.

Using the maneuver of the forced exhalation, the freight and operating speed indicators are measured (FEV 1, the ratio of FEV 1 / FELE, the maximum averaged volumetric speed - SOS 25-75, the maximum volumetric velocity at levels 25, 50 and 75% of freak, wizard).

Forced Lung Life Capacity (Fire)

Fire is the maximum amount of air that a person can exhale after the most deep breath. Fire decreases with many types of pathology, and increases only in one case - with acromegaly. In this disease, all other pulmonary parameters remain normal.

Reasons for the decline of Fan:

1. Pathology of lung tissue (resection of the lungs, atelectasis); The states under which the tensile of pulmonary tissue decreases (fibrosis, stagnant heart failure). With obstructive pulmonary diseases, the freak is also reduced by slowing the emptying of the lungs.

2. Pathology of pleura and pleural cavities (thickening of pleura, pleural effusion, tumors of pleura with the propagation on the pulmonary tissue).

3. Reducing the size of the chest. The lungs cannot parse and fall into full, if the movements of the chest wall (including the abdominal component) are limited.

4. Violation of the normal operation of the respiratory muscles, primarily the aperture, intercostal muscles and muscles of the abdominal wall, which provide fragrance and emptying of the lungs.

Thus, it is not difficult to establish the reason for the decrease in the cliff in each case.

It should be remembered that the freak is the maximum forced expiratory life capacity of the lungs, in patients with obstructive diseases of the lungs, it can be substantially less than the blast, measured during calm breathing.

With severe obstructive diseases of the lungs, the exhalation time may exceed 15-20 seconds, and the expiratory flow at the end of the maneuver can be so small that the spirometer with difficulty perceives it. Performing prolonged forced exhalation may be difficult and caused the patient's discomfort. In order to avoid these phenomena instead of cliff lately The indicator of the FEV 6 is the volume of air exhaled in 6 seconds. Healthy faces of the FEV 6 slightly smallerlyble. In addition, the FPV 6 is better reproducible than the freak. The ratio of FEV 1 / OFV 6 reflects the degree of restriction of the air expiratory flow and allows you to predict the decrease in FEV 1 in smokers. Unlike Maneuver, the hotter, the shorter Maneur of the FEV 6, which does not require the achievement of the plateau on the curve volume-time, reduces the risk of syncopal states in heavy patients during the study and reduces fatigue as a patient and medical personnel. At the same time, the proper values \u200b\u200bof FEV 6 are not fully developed, so it is still recommended to continue to operate the traditional cliff.

The volume of forced exhalation for 1 second (OFV1)

Of all the indicators, the most important is the maximum amount of air, which a person can exhale over the first second Maneuver Fel - FEV 1. It is relatively independent of the effort attached during the exhalation maneuver, and reflects the properties of lungs and respiratory tract. FEV 1 is the most reproducible, often used and the most informative indicator of spirometry.

When the air flow rate is reduced, for example, in emphysema, COPD, bronchial asthma, fibrosis, FEV 1 decreases, respectively, the severity of obstruction. It is also decreasing, but, as a rule, to a lesser extent. With restrictive disorders (restriction of lung fragrances), for example, with pulmonary fibrosis, FEV 1 is also reduced. The question arises: how to distinguish, what caused the decline in FEV 1 - restriction or obstruction? For an answer to this question, it is necessary to calculate the ratio of FEV 1 / Ferge.

Spirometry refers to the instrumental methods of lung diagnostics, which are divided into three large groups: used for morphological visualization, to evaluate the function and allowing to evaluate both of these indicators.

To study the morphological changes in the bronchopulmonary system, X-ray, CT and MRI are used. These methods are widespread, but they do not allow to judge how the respiratory system functions.

Best way Evaluate the function of external respiration is a spirometry that allows not only to confirm the diagnosis, but also to determine the severity of the patient's condition.

Reference. Spirometry is a study of an airflow, which makes it possible to estimate the function of external respiration (FVD) in many indicators.

Conduct spirometry with the help of a special apparatus represented by a computer with software and functional part. The latter consists of a mouthpiece, air conductive part and air flow sensors.

The patient pursues mouthpiece in the mouth and breathes into him as the doctor says. Air passes through the conductive part and falls on the sensor. The latter registers strength, speed and flow rate, transforming this data in various indicators. The computer records all the results, draws graphs and tables.

With the help of the data obtained, a general view of the FVD is built.

Reference. The function of an external respiratory is called the ability of the respiratory system to carry out air from the external environment into the tissue of the lungs and in the opposite direction, as well as the possibility of diffusion of gases through the tissue of the lungs.

The FVD assessment is an important diagnostic and prognostic criterion, therefore spirometry is often carried out by patients with lung diseases.

When a study is prescribed

Spirometry is shown when it is necessary to confirm the presence of a disease of the respiratory system, find out the degree of its severity and establish the effectiveness of the treatment.

Indications for the purpose of the study are:

• The presence of symptoms of damage to the bronchial tree, suspicion of the occurrence of bronchitis;
• The need to confirm or disprove the diagnosis of bronchial asthma, to determine its severity, stage, degree of control;
• Differential diagnosis between bronchial asthma and chronic bronchitis;
• Definition of FVD after the suffered diseases of the lungs;
• Determination of the presence of the obstruction of the respiratory tract and its severity;
• Determination of the disorder of the FVD in restrictive pathologies (pleurisites, alveolitis, pneumonia);
• Evaluation of the degree of harm to health in workers who are in the risk group on respiratory pathology (bakers, confectioners, miners, builders);
• Professional inspection of athletes before heavy exercise;
• Monitoring changes in patients passing the course of therapy due to bronchopulmonary pathology.

Methods of evaluation of FVD.

Reference. At the moment there is not so many techniques that allow you to know the function of external breathing. Only the most accurate and minimally invasive tests that minimize the possibility of error and the risk of infectious complications are used.

The most common of these methods are:

• Spirometry and spirography. Allow all the indicators of the function of external respiration, but do not exclude the possibility of error due to the error in conducting the technique.
• Bodiletismography. Technically similar to spirography, but has greater accuracy. The difference is that the patient is placed in a hermetic chamber during the study. The computer registers not only indicators in the tube, but also the pressure inside the chamber. The patient must inhale the air from the chamber and exhale it into the tube. In this case, the likelihood of the error is minimal.
• Pneumotachography. Technically, the method is similar to spirography, but only one indicator measures - the volumetric speed of breathing. Currently applies less frequently of other methods due to low informativeness.
• Picofloumetria. A very simple and affordable way to determine the FVD anywhere, even at home. A mechanical device with a mouthpiece and a meter of air flow shows a peak exhalation rate for 1 second. Other indicators The device does not define. It is often used by patients with chronic bronchitis and bronchial asthma to determine the beginning of exacerbation.

Preparation for research

Reference. This technique does not require special patient preparation. The only condition of its implementation is the elimination of all factors that may affect the result.

On the day of spirometry it is impossible:

• Smoking;
• Drinking alcohol;
• Eat a large amount of food, better to abandon food before the test;
• Perform physical exercisesEven after lifting the stairs, it is necessary to wait half an hour;
• Accept medicationscapable of affecting the respiratory function, it is better to abandon the reception of any drugs before testing.

In addition, the patient should have loose clothing, not squeezing the chest and stomach. Corsets and bandages before the procedure should be removed.

Methodology

In front of spirometria, the doctor measures the mass of the patient's body and its growth, records indicators to the computer, the patient's data is also introduced into the program, its age, gender and full name.

Reference. After that, the surveyed sits on the chair, while maintaining the most smooth posture. Extra Movements During the methods, prohibited due to possible distortions of the results.

Disposable mouthpiece put on the device, after which the doctor teaches the patient to breathe correctly. He explains in advance what a calm breath, deep breathing, forced exhalation and inhale. Then the clamp is put on the nose of the patient, and the mouthpiece is placed in the mouth and ask to close his lips tightly.

The doctor launches the program and gives the instruction to the patient. Initially, he is asked to breathe in a calm usual pace. Then - to make the most deep breath and exhalation. After that, the patient breathes as quickly as possible and superficially. Instructions can be changed in accordance with the goals set.

All this time, the program to record the information obtained, draws the graphs, calculates spirometry indicators. After that, all the results are displayed on the doctor's computer screen. As a rule, the technique is repeated twice or three times to make sure that there is no error in the execution technique.

Reference. If necessary, to distinguish reversible changes in the bronchial tree from irreversible, salbutamol is administered to the patient. Spirometry is carried out to the sample with the drug and 15 minutes after its introduction.

Spirometry with bronchodiliac allows you to spend differential diagnosis Between the bronchial asthma and COPD, therefore apply it is not always.

Spirometry - normal

Spirometry allows you to determine the set of external respiratory indicators and compare them with regulatory values. The latter can differ significantly in persons of different sexes and age.

Attention. In each case, the norm indicator sets the program according to the initial data entered. Norms are calculated as a percentage of the rate indicator.

During the method, the following spirometry indicators are determined:

• Lightweight lung tank. This is the volume of gases that can accommodate lungs with maximum filling. Usually, average Job about 3,5l, but it can differ significantly among athletes, old people and adolescents. Normal is considered to reduce the blade not more than 20% of the required.
• Forced vital capacity. Shows the amount of maximum exhalation. It must be equal to 80% of the measured jerk.
• Volume of backup inhale and exhalation. It is a difference between the maximum and calm breath, maximum and calm exhale. Normally equal to about 1.5 liters 30-40% of the jam);
• Total lung capacity. It differs from the life capacity of what takes into account the so-called "dead space" - that part of the respiratory system, which is not involved in gas exchange. This includes all airproof paths from the nasal cavity to bronchiol. Norma, I was about 2 times more.
• The volume of the forced exhalation in 1 second. Shows the magnitude of the exhalation committed by the patient in the first second at the maximum speed. The norm consider the decrease in the indicator no more than 25%, the must calculate in percentage of jersee.
• Index Tiffno. He is the attitude of the FEV1 to the jerk. Normally, the index is 0.7 or more.

Reference. These are the most informative indicators of spirometry that allow you to determine the main types of pathology. respiratory system. Depending on the tasks set, the number of indicators can be increased.

Features research in children

Children are difficult to explain exactly how to breathe during spirometry. They often make mistakes, can be capricious or refused to perform a test.

Reference. Up to 5 years, it is meaningless to conduct a study, since before this age, children cannot make the right exhalation. Any increase in load - cry, cry, excessive mobility - distort the test results. Therefore, it makes children in a calm state.

It is recommended to conduct a technique in the children's office of functional diagnostics, where there are toys, distracting pictures and a friendly atmosphere. Children's diagnostician can find approach to children and explain to them what to do.

Up to 9 years it is desirable to use auxiliary pictures. For example, show a child a festive cake with a candle, which he can blew, if the air will be exhaled correctly. During spirometry, it is important to ensure that the mouthpiece is tightly covered by lips and the air did not pass by him.

Methods should repeat several times, and then compare the indicators. If the two results obtained one after another differ slightly, spirometry can be considered informative. Otherwise, the study should be repeated once again or postpone for a while.

The interpretation of the data obtained in children also has its own characteristics.

Reference. There are special formulas that translate regulatory figures of adults, recounting them with children's age. As a rule, use programs that automatically issue results, taking into account the age of the surveyed.

Spirometry - decoding

During the interpretation of the results respond to two questions: whether there are changes in the FVD and what type changes occur if they are.

There are three types of disorders of an external respiratory function:

• Obstructive. Due to the overlap of the air paths at any level. It is characterized by a decrease in the FEV1 and the index Tiffno. It occurs most often with bronchitis, COPD and bronchial asthma.
• Restrictive. Due to a decrease in the functioning tissue of the lungs. It is characterized by simultaneous decrease in FEV1, jerking and cliff. The Tiffno index remains within normal values. It occurs during pneumophybrosis, sarcoidosis, pneumoconiosis, inflammatory diseases of the pulmonary fabric.
• Mixed. All indicators are reduced, which is indicated by the simultaneous presence of obstructive and restrictive component. It occurs during the atelectase.

More detailed decoding of all indicators and graphs drawn by a computer allows you to suspect specific pathology.

To which doctor to turn

Pulmonologist is engaged in lung diseases, which gives a direction for research. In the event that the appropriate device is in the clinic, the direction can give the precinct therapist. For children, there are appropriate children's experts - a children's pulmonologist and a precinct pediatrician.

In the event that the study is carried out in order to identify bronchial asthma, an allergist can appoint spirometry. Any specialist who needs to check the patient's external breathing function can make such an appointment.

Reference. Conduct a study in the office of functional diagnostics. There is a diagnostician who has a certificate that allows you to work with spirometer.

The diagnostics monitors the correctness of the technique, gives instructions to the patient, after which the conclusion is written on the basis of the data obtained. Deciphering the result, most often, does a doctor who has appointed research.

Patients with chronic diseases of the bronchology system can perform an alternative method for independently. To do this, they have pocket picofloometers showing the peak speed of exhalation.

Reference. Picfloumometry is less informative than spirometry, but allows in general terms to determine the function of external respiration in a few seconds. You can purchase such an appliance in the medical equipment store.

Contraindications

Spirometry is a non-invasive method, the risks of the development of complications in its implementation are minimal.

Attention. However, it should be borne in mind that during the study, due to the special technique, the brain breathing briefly experiencing hypoxia. In addition, the pressure in the lungs, in the chest and in the vessels of the small circle of blood circulation, increases the load on the respiratory muscles and the abdominal muscles.

From here there is a series of contraindications to the conduct of spirometry:

• Childhood. Children under 5 years old cannot clearly comply with the instructions during the study, because spirometry preschoolers are not prescribed.
• Senile age. People over 75 years old, as a rule, have several diseases at once of cardio-vascular systemAs a result, the risk of complications increases. In addition, at this age, the technique is less informative due to the physiological aging of the pulmonary fabric.
• Operational interventions less than 2 months before the study. First of all, operations on the chest and the abdominal cavity. The increase in pressure and the load on the muscles may lead to the fact that postoperative seams will disperse.
• Reception of antiagregants and anticoagulants. In this case, the increase in pressure in a small circulation circle can cause bleeding.
• Pneumothorax in history. Especially the restriction relates to spontaneous pneumatic discs, which can recur by increasing the load on the lungs.
• Fracture ribs. In this case, the chest should be as small as possible. Spirometry is recommended to postpone until the fracture is completely heal.
• Cardiovascular pathology in the decompensation stage. This group of contraindications consists of high degree of heart failure and arterial hypertension.
• Glaucoma. An increase in intraocular pressure is also a contraindication to the study.
• Acute stroke or heart attack. In the event of these states, the study must be postponed at least a month.

Difference of spirometry from spirography

The difference between two concepts lies in word formation according to the rules of Greek terminology. Medical names indicated by Latin and greek tonguesare translated in parts that form them.

The term "spirometry" consists of two particles: "spiro-" and "-metry". The first translates as breathing, breathe, and the second is the measurement. The term "spirography" has the same first part, and the second part "-graphy" means to record.

Reference. It follows that spirometria refers to the process of measuring the function of external respiration. Spirography is an image or record of the results obtained on paper. As a rule, the terms consider synonyms, because during the study, the result is always written on paper.