Interpretation of pulmonary function tests : a practical guide

272 Pages·2009·1.158 MB·English

by  Robert E. Hyatt MD, Paul D. Scanlon MD, Masao Nakamura MD

Interpretation
of Pulmonary
Function Tests
A Practical Guide
ThirdEdition

Interpretation
of Pulmonary
Function Tests
A Practical Guide
ThirdEdition
RobertE. Hyatt,MD
EmeritusMember
DivisionofPulmonaryandCriticalCareMedicine
MayoClinic,Rochester,Minnesota;
EmeritusProfessorofMedicineandofPhysiology
CollegeofMedicine,MayoClinic,Rochester,Minnesota
PaulD.Scanlon,MD
Consultant
DivisionofPulmonaryandCriticalCareMedicine
MayoClinic,Rochester,Minnesota;
ProfessorofMedicine,CollegeofMedicine,
MayoClinic,Rochester,Minnesota
Masao Nakamura,MD
DivisionofPulmonaryMedicine
Ooizumi-kinenHospital
Shiroisi-shiMiyagi-ken,Japan
Philadelphia (cid:127) Baltimore (cid:127) NewYork (cid:127) London
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LibraryofCongressCataloging-in-PublicationData
Hyatt,RobertE.
Interpretationofpulmonaryfunctiontests:apracticalguide/RobertE.Hyatt,
PaulD.Scanlon,MasaoNakamura.—3rded.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN-13:978-0-7817-7882-4
ISBN-10:0-7817-7882-4
1. Pulmonaryfunctiontests.I. Scanlon,PaulD.(PaulDavid)
II. Nakamura,Masao,M.D.III. Title.
[DNLM:1. RespiratoryFunctionTests.2. LungDiseases—diagnosis.
WF141H992i2008]
RC734.P84H932008
616.2(cid:1)40754—dc22 2008016434
Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandtodescribe
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Contents
Preface vii
Acknowledgments ix
ListofAbbreviations xi
1. Introduction 1
2. Spirometry: Dynamic Lung Volumes 5
3. Static (Absolute) Lung Volumes 27
4. Diffusing Capacity of the Lungs 41
5. Bronchodilators and Bronchial
Challenge Testing 51
6. Arterial Blood Gases 63
7. Other Tests of Lung Mechanics:
Resistance and Compliance 75
8. Distribution of Ventilation 87
9. Maximal Respiratory Pressures 93
10. Preoperative Pulmonary Function
Testing 101
11. Simple Tests of Exercise Capacity 105
12. Patterns in Various Diseases 111
13. When to Test and What to Order 119
14. Approaches to Interpreting Pulmonary
Function Tests 129
15. Illustrative Cases 147
Appendix 249
Index 253
v

Preface
ThefirsttwoeditionsofInterpretationofPulmonaryFunctionTests
werewell-receivedandmetourgoalofappealingtoawide,varied
audienceofhealthprofessionals.Inthis,thethirdedition,wehave
added a section to Chapter 7 on the forced oscillation technique
for measuring respiratory system resistance, a procedure that
has become popular in recent years. Other additions include a
discussion in Chapter 5 of the measurement of exhaled nitric
oxide, which is becoming useful in the study of asthma. The
most recent guidelines (2005) on standardization of pulmonary
function testing and interpretation published by the American
Thoracic Society/European Respiratory Society Task Force have
beenaddedtoChapter14.
RobertE.Hyatt,MD
PaulD.Scanlon,MD
MasaoNakamura,MD
vii

Acknowledgments
We thank Patricia A. Muldrow for her secretarial contributions.
We appreciate the assistance of the Division of Media Support
Services in revising the illustrations. Without the help of LeAnn
Stee, Jane M. Craig, Kenna Atherton, and Roberta Schwartz in
the Section of Scientific Publications this book would not have
reachedfruition.
ix