By Robert E. Hyatt MD, Paul D. Scanlon MD, Masao Nakamura MD
- A new specialize in interpretation of complicated disorders
- Coverage of impulse oscillometry
- Solution website to comprise textual content in addition to try out generator to deal with cases
- "Pearls" relating to functionality or interpretation of key tests
- Carefully chosen authoritative references
- Clear illustrations demonstrating dozens of PFT patterns
- Illustrative cases
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Extra info for Interpretation of Pulmonary Function Tests
1). On the basis of these considerations, conditions that reduce the diffusing capacity can be determined (Table 4-1). The major ones are listed here. indd 37 30/01/14 6:03 PM 38 4 n Diffusing Capacity of the Lungs TABLE 4-1. Emphysema: Although lung volume is increased, alveolar walls and capillaries are destroyed, and thus, the total surface area is reduced. Reduction of the Dlco in a patient with significant airway obstruction strongly suggests underlying emphysema. Lung resection: If only a small portion of the lung is resected (such as a lobe in an otherwise healthy patient), capillary recruitment from the remaining normal lung can result in an unchanged Dlco.
The diffusing capacity of the lungs (Dl) estimates the transfer of oxygen from alveolar gas to red cells. The amount of oxygen transferred is largely determined by three factors. One factor is the area (A) of the alveolar– capillary membrane, which consists of the alveolar and capillary walls. The greater the area, the greater the rate of transfer and the higher the Dl. Area is influenced by the number of blood-containing capillaries in the alveolar wall. The second factor is the thickness (T ) of the membrane.
The Diffusing Capacity for Carbon Monoxide The diffusing capacity of oxygen (Dlo2) can be measured directly, but this is technically extremely difficult. Measuring the diffusing capacity of carbon monoxide (Dlco) is much easier and provides a valid reflection of the diffusion of oxygen. In essence, the difference between alveolar and venous carbon monoxide tension (ΔPCO) is substituted for oxygen in Eq. 1. Several techniques for estimating Dlco have been described. The most widely used is the single-breath (SB) method (SBDlco).
Interpretation of Pulmonary Function Tests by Robert E. Hyatt MD, Paul D. Scanlon MD, Masao Nakamura MD