The Place Of The Spirometer In Diagnosing Lung Conditions

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 diseases that fall under the definition of RLD include scoliosis, neuromuscular conditions such as amyotrophic lateral sclerosis (ALS), muscular dystrophy (MD), obesity and sarcoidosis. The common symptom that alerts people to the need to see a doctor is always shortness of breath. Sarcoidosis is an autoimmune condition in which the lungs become peppered with inflamed tissue referred to as granulomas. These mostly involve the lungs or the skin. Individuals may develop symptoms spontaneously and recover after a few months, maybe years. Other people never notice the condition and learn about it only after investigations for another condition.

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.

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 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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