Diagnosis Of Lung Conditions With A Spirometer

By Jaclyn Hurley


Spirometry is the most common type of test for examining lung function. It measures the volume and speed of air breathed in and out by the lungs. The spirometer is an essential tool in assessing conditions like asthma, cystic fibrosis, Chronic Obstructive Pulmonary Disorder (COPD) and pulmonary fibrosis. A spirogram can differentiate between two types of abnormal breathing patterns, restrictive and obstructive.

A person with a restrictive lung disorder (RLD) has difficulty expanding the lungs when drawing in breath. This causes a decrease in lung volume and forces the lungs to work harder. Both oxygenation and ventilation are negatively affected. Pulmonary fibrosis, or scarring of the lungs, falls under the umbrella of RLD. Here, the normal tissue of the lung is dotted with lesions of scar tissue, creating a honeycomb-like appearance. Pulmonary fibrosis is badly understood, normally gets worse with time and is frequently fatal. Fortunately, it is a rare condition.

Other conditions that contribute to restrictive lung disease include obesity, sarcoidosis (an autoimmune condition), scoliosis and neuromuscular diseases including amyotrophic lateral sclerosis (ALS) and muscular dystrophy (MD). The primary presenting symptom that drives people to the doctor is almost always difficulty in breathing. Sarcoidosis is characterized by swollen and reddened tissue called granulomas. These mostly affect the skin and the lungs. Some people develop symptoms suddenly and recover spontaneously after a few months or years. Others never experience any symptoms; the condition is incidentally following an x-ray for another reason.

The main features of obstructive lung disorders are obstructed and reddened airways. Airflow is obstructed, resulting in difficulty breathing out and, inevitably, numerous visits to the hospital. A diagnostic feature of OLD is the inability to expire 70% of breath in one second. Examples of OLD include COPD, bronchitis and asthma.

Asthma, caused by inflammation of the airways, is a common respiratory condition most often characterized by coughing, wheezing and shortness of breath. Less common symptoms include sighing, fatigue and rapid breathing. Asthma is occasionally life-threatening.

The most serious symptom of CF is impaired breathing. Cystic fibrosis affects the lungs, pancreas, liver and intestine. Twenty-first century improvements in treatment and diagnosis have resulted in a much better prognosis than 50 or 60 years ago. In 1959, the median age of survival was only six months. As of 2008 in the United States, this had risen to 37.5 years; in Canada, it improved from 24 years in 1982 to 47.7 years in 2007. In Russia, the cost of medical treatment is often prohibitive and lung transplants do not take place. Here, the median age of survival is only 25 years.

The term COPD covers conditions like emphysema and chronic bronchitis. In emphysema, the delicate tissues lining the lungs become irreversibly damaged, most commonly from exposure to cigarette smoke. This limits the person's ability to exhale. While there is no cure for emphysema, smoking cessation will reduce disease progression.

Spirometry is an important diagnostic tool in respiratory medicine. Distinguishing between obstructive and restrictive conditions, it enables doctors to inform interventions and determine prognoses.




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