The Use Of A Spirometer To Diagnose Lung Disease

By Jaclyn Hurley


One of the primary tests for assessing lung disorders is the use of spirometry. A spirometer measures the speed and volume of air inspired and expired by the pulmonary system. It plays a critical role in evaluating conditions like cystic fibrosis, pulmonary fibrosis, chronic obstructive pulmonary disease and asthma. A spirogram will tell the diagnostician whether a patient has one of two categories of abnormal lung function, obstructive or restrictive.

In persons suffering from restrictive lung disease (RLD), the expansion of the lungs is impaired when breathing in. This causes a decrease in lung volume, making it more difficult for the person to breathe, impairing both oxygenation and ventilation. One type of condition underlying RLD is pulmonary fibrosis. Pulmonary fibrosis is associated with scarring of the lungs, resulting in a honeycomb-like appearance. While rare, the disease is poorly understood and is frequently fatal.

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.

Obstructive lung disease (OLD) is characterized by inflamed and obstructed airways. OLD obstructs airflow, leading to difficulty exhaling and frequent trips to the hospital. Bronchitis, asthma and COPD are examples of obstructive lung diseases. A common feature of OLD is loss of the ability to exhale 70 percent of breath within one second.

One of the most common respiratory ailments, asthma most often features wheezing, coughing and breathlessness. Less commonly, patients experience fatigue, rapid breathing and appear to sigh frequently. Occasionally, asthma may be life-threatening.

Cystic fibrosis affects the lungs, liver, intestine and pancreas. Shortness of breath is the most serious symptom of cystic fibrosis. Improvements in diagnosis and treatment have extended the life span for people with CF. In 1959, the median survival age was 6 months. In the United States, it had increased to 37.5 years by 2008. In Canada, the median age at survival grew from 24 to 47.7 between 1982 and 2007. Patients are not so lucky in Russia, where lung transplants are not available and basic medical treatment is expensive. Here, the median age of survival is only 25 years.

The designation chronic obstructive pulmonary disease (COPD) includes conditions like chronic bronchitis and emphysema. With emphysema, the delicate lining of the lung becomes irreversibly damaged. This is usually a consequence of exposure to cigarette smoke, which restricts the patient's ability to breathe out. Although there is as yet no cure, removing the stimulus of cigarette smoke does bring improvement.

Spirometry is an essential screening tool for distinguishing between obstructive and restrictive lung diseases. Obstructive conditions include asthma, COPD and bronchitis. Both chronic bronchitis and emphysema contribute to chronic obstructive pulmonary disease. Restrictive lung diseases include pulmonary fibrosis, sarcoidosis, obesity hyperventilation syndrome, sarcoidosis, muscular dystrophy and amyotrophic lateral sclerosis (ALS).




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