Pulmonary Function Tests Other tests of lung function

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Pulmonary Function Tests Other tests of lung function: 1. Lung mechanics -Resistance -Compliance 2.

Pulmonary Function Tests Other tests of lung function: 1. Lung mechanics -Resistance -Compliance 2. Distribution of Ventilation (N 2 delta) 3. Maximal Respiratory Pressures (MIP, MEP)

V/Q ratio

V/Q ratio

V/Q mismatch (3 -compartment model)

V/Q mismatch (3 -compartment model)

Lung volumes and capacities

Lung volumes and capacities

How to measure FRC (RV, TLC) ? • Nitrogen washout method • Inert gas

How to measure FRC (RV, TLC) ? • Nitrogen washout method • Inert gas dilution technique • Plethysmography

Resistance

Resistance

Volume dependence of airway resistance (Raw) RV SRaw (cm. H 2 O/L/sec) 4 3

Volume dependence of airway resistance (Raw) RV SRaw (cm. H 2 O/L/sec) 4 3 2 1 TLC 0 2 4 6 Lung Volume (liters) 8

Compliance

Compliance

Compliance

Compliance

Ventilatory Mechanics: Healthy 100 % VC Pcw 80 PRS 60 40 20 PL 0

Ventilatory Mechanics: Healthy 100 % VC Pcw 80 PRS 60 40 20 PL 0 -60 -40 20 -20 0 Pressure (cm. H 2 O) 40 60

Ventilatory Mechanics: Healthy 100 ΔP % VC ΔV 80 ΔP 60 elastic WOB ΔV

Ventilatory Mechanics: Healthy 100 ΔP % VC ΔV 80 ΔP 60 elastic WOB ΔV RV elastic and resistive 4 work of breathing is minimized when tidal breathing occurs 3 within the compliant portion of the respiratory systems 2 P-V curve ΔP 20 SRaw (cm. H 2 O/L/sec) 40 ΔV 1 TLC resistive WOB 0 -40 20 -20 0 Pressure (cm. H 2 O) 40 4 6 Lung Volume (liters) 0 -60 2 60 SRaw as lung volume because the airways distend as the lungs inflate, and bigger airways have lower resistance (*Poiseuilles’ Law*). The opposite is also true, of course! 8

Ventilatory Mechanics: Healthy Begin Exercise IC IC VT

Ventilatory Mechanics: Healthy Begin Exercise IC IC VT

Ventilatory Mechanics: Healthy 8 TLC Volume (liters) EILV 6 4 2 EELV IRV VT

Ventilatory Mechanics: Healthy 8 TLC Volume (liters) EILV 6 4 2 EELV IRV VT EELV R 0 V -40 -30 -20 -10 0 10 20 30 40 50 Pressure (cm. H 20) IC

Dynamic hyperinflation during exercise IRV

Dynamic hyperinflation during exercise IRV

Diffusion capacity (DLCO, DLCO/VA, Tco, Kco)

Diffusion capacity (DLCO, DLCO/VA, Tco, Kco)

Mechanism of hypoxaemia

Mechanism of hypoxaemia

Hypoxaemia, hypercapnia in clinical cases

Hypoxaemia, hypercapnia in clinical cases

Respiratory and metabolic shifts chronic acute chronic

Respiratory and metabolic shifts chronic acute chronic

Exercise tests in lung diseases 1. Exercise-induced asthma (EIA) - FEV 1 2. Interstitial

Exercise tests in lung diseases 1. Exercise-induced asthma (EIA) - FEV 1 2. Interstitial lung disease (ILD) - SAT 3. Exercise tolerance in rehabilitation (COPD) cardiopulmonary exercise (CPX). Important variables: - work rate (watts), Sp. O 2, ABG - VO 2, VCO 2, RQ, VE - lactate threshold (LT) - breathing reserve (1 -VEmax/MVV) - heart rate reserve (1 -HRmax/220 -age)

Mechanism of exercise-induced hypoxaemia

Mechanism of exercise-induced hypoxaemia

Noninvasive determination of lactate threshold by the V-slope method

Noninvasive determination of lactate threshold by the V-slope method

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