Gas Exchange, Gas Change (Pulmonary Function Test)
Entering or leaving the lungs in a minute volume of ventilation air-Mune "minute ventilation" is called. 6-8 liters at rest.
Some diseases require less ventilation (hypoventilation), some diseases require more ventilation (hyperventilation) occurs.
Hypoventilation causes chronic obstructive lung disease, pneumonia, tuberculosis, widespread fibrosis, pleural effusion, pneumothorax, general anesthesia, taking drugs such as morphine and the luminal rest hipoventilasyona causes.
According to various stimulus associated with recurrent spontaneous ventilation during sleep and is composed of episotları. Sleep apnea can vary from one consisting of ventilation in some patients episotları (sleep apnea syndrome). Thus, these persons is a significant hypoxemia and hypercarbia (respiratory acidosis) may occur and may develop respiratory and cardiac insufficiency. Changes in arterial blood gases of sleep apnea increases sympathetic and parasympathetic tone. For example, increased vagal tone may cause bradycardia atropine eliminated the bradycardia.
The main reasons for developing sleep apnea the muscles of the respiratory motor function decline and growing up and obstruction of the respiratory tract.
Hyperventilation causes hyperventilation normally consists of a growing effort by the degree. Hypoxia, hyperthyroidism, fever, excitement (anxiety), hyperventilation syndrome, cerebral hemorrhage, trauma, and andrenalin, taking drugs such as progesterone and testosterone develop hyperventilation at rest.
Diffusion of a gas from a region of high pressure passed into a region less pressure. Pulmonary diffusing capacity (DA) 1 min 1 mm Hg, alveolar-capillary oxygen pressure difference {(Aa) 02} days of oxygen volume in alveolar capillaries (V02), dir. DA = V02 / (Aa) 02 formula is calculated.
V02 = 250 ml / min, (Aa) O2 = 10 mm Hg, the OR = 250/10 = 25 ml / mmHg / min. Diffusing capacity increases with increasing body surface.
Diffusion capacity of the major reasons for the reduction of alveolar hypo-ventilation, alveolar-capillary block, ventilation / perfusion imbalance, and pulmonary circulatory abnormalities.
Perfusion (pulmonary circulation), lungs proper ventilation perfusion is an important factor for gas diffusion. Ventilation / perfusion imbalance by reducing the diffusion of hypoxemia (02 reduction) and hypercapnia (increase in C02) causes. Thus, the normal abnormal ventilation-perfusion or normal ventilation-perfusion regions of abnormal gas exchange effects and reducing the gas di-fusion of hypoxemia and hypercapnia can cause more serious cases.
Especially with chronic bronchitis, emphysema, pulmonary diseases and diffuse fibrosis, pulmonary vessels in cases of pulmonary embolism, resection and multple shrinking diameters, tıkanarak and decreased the number of perfusion abnormalities and pulmonary hypertension develops. Heart diseases, anemia and perfusion abnormalities may occur tirotok-sikozlarda.
Arterial blood gases, arterial blood gas main function of the lung alveolar capillaries to provide oxygen to pass and the capillaries are disposed of more than C02 understanding of abnormal pulmonary function in an objective way to measure arterial blood of 02 and C02.
However, a significant dysfunction gelişmemişse 02 and C02 levels remain normal. The main reasons for the increase in C02 reduction of 02 and pulmonary and cardiovascular diseases. Anemia also may be due.
Lips, tongue and fingertips syanozu classical clinical symptom of hypoxemia. However, this type of evaluation can be misleading. Shows little, such as by reducing or masking syanozu anemia than hypoxemia, polycythemia, whereas hypoxemia stimulates syanozu shows that as people collapsed. 02 For these reasons, arterial blood pressure (P02) and C02 pressure (pC02) assessment provides a more objective measurement of hypoxemia and hypercarbic. The main clinical signs of hypoxemia syanoz, severe exertional dyspnea, congestive heart failure, polycythemia, and restlessness, cerebral disorders such as insomnia and personality changes. P02 have a healthy adult living in the sea level was 90-100 mm Hg. P02 decreases with increasing age. 75 mm at the bottom of the normal value can be considered as HgP02. P02 Respiratory failure is usually less than 60 mm Hg. 25-35% should be given to 02 patients with treatment-related hypoxemia düzelmemişse. This can be used for a long time yoğunlukda 02. 02 Treatment of high concentration such as 100% "oxygen poisoning" can cause.
Normally, arterial blood pC02 is 35-45 mm Hg. Chronic increase of C02 (or respiatuar hperkapni acidosis), the main symptom of respiratory failure.
Respiratory acidosis clinical signs of drowsiness, confusion, difficulty speaking, the distal tremor, muscle spikes, headaches, small pupil, warm moist hand, papillary edema, and coma. These symptoms are not specific. Arterial gases (P02, pC02, and bicarbonates) are evaluated by measuring the acidosis is respiratory or metabolic.
Preoperative evaluation, preoperative preparation
There are a lot of complications related to anesthesia in surgical intervention. Lung, heart and upper abdominal surgery within 24 hours of the first major abnormalities in lung volumes such as a decrease in vital capacity is 50% or more. This reduction will take a week or so recovered. Temporary reduction of pain and muscle function in lung vo-lümlerinin related corruption.
Hypoxemia is quite common in surgery. Hypoxemia immediately after surgery, usually consisting of a reduction in lung volumes after ilgilidir.Bu period lasts for weeks or sometimes regress. The two major defense of the lungs and coughing in the postoperative period purification mukosilyer reduced.
Operative complications is closely related to the preoperative and intraoperative factors.
Preoperative Factors
Chronic lung diseases, especially chronic obstructive pulmonary disease has a lot of important complications of the surgery. During this period, lung function tests measured the degree of abnormality increases with increasing severity of them on the surgical complication. Forced vital capacity 1 seconds (ZVK1) 0.8 liters of surgical intervention is less often applied. Smoking, obesity, age and nutrition bozukluklarınında has to do with surgical complications. Surgical intervention before the patient's lungs, heart and other organs of the fızyopatalojik abnormalities should be evaluated together.
Intraoperative factors
This issue features of anesthesia, surgery type, location and size of the main factors in the incision.
Overall Evaluation for Surgical Intervention
The patient's background and examination, chest radiography, pulmonary function and blood gases are examined. Chest radiograph should be drawn, regardless of the type of surgical intervention. ZVKl more than 2 liters, or 80% of the normal value is suitable for pneumonectomy. ZVKl 2 liters or less than 80% of the account in accordance with the formula is written below postpnömonektomi ZVKl.
Preoperative ZVK1X Postpnömonektomi ZVKl =% remaining lung perfusion
If you ZVKl postpnömonektomi more than 800 or 40% of normal, or more applicable to the pneumonectomy.
Preparation of the patient before surgery
1. Smoking cessation for at least 8 weeks prior to surgery.
2. Existing lung, heart and other diseases to be treated.
3.Özellikle in patients with chronic obstructive pulmonary surgery treatment should be provided for up to 48-72 hours. For example, bronchodilator drugs (if necessary, steroids) and antibiotics should be given.
4. The weakening of the patients fat.
5. She thoroughly explained the importance of postoperative cough and breathing exercises should be done and the required application.
Showing posts with label Lung Function Test. Show all posts
Showing posts with label Lung Function Test. Show all posts
Pulmonary Function Test Lung Mechanics
Mechanics of Breathing (Lung Tests)
Inspiration and expiration of air entering or exiting the factors that facilitate or complicate related to respiratory mechanics. These factors are collected in 3 groups: 1 The flexibility of the lungs, 2 bronşiyoUerde bronchus and air flow resistance, 3 frictional resistance changed the shape of the thorax and lung tissues.
A test that measures lung compliance flexibility. Shows the relationship between pressure and volume changes. Normally, lung compliance is 0.2 L/smH20. Reduction in water pressure in the lungs and pleura in other words, one part expands 0.2 liter (0.2 liters of air into the lungs) or the increase in pleural pressure in the lungs, a portion of water shrinks 0.2 liter (0.2 liter air out the lungs). Compliance is less than the decreased flexibility of the lungs (fibrosis, silicosis, mitral stenosis).
Airways resistance assessed by measuring the relationship between air flow and pressure. Normally, airway resistance H20/L/sani-yedir 1.6 sm. In other words, a second input or output of 1 liter of air breathing ways to be a force for the 1.6 portion of water pressure. Respiratory resistance emphysema, asthma, obstructive diseases, such as increases. Tests that measure pulmonary mechanics is done in laboratories with sophisticated organized and well-trained professionals. Therefore, these tests can be measured more easily and instead of showing the change of respiratory mechanics impairment tests in parallel, for example, forced vital capacity, maximal expiratory flow-volume curves, maximal respiratory capacity is used.
Forced vital capacity (FVC), forced vital capacity at this time is called. Vital capacity is done as fast as possible. FVC test examined the relationship between volume and time. Normally ZVK'nın 75% in one second (ZVKl), 85% second per second (ZVK2) and 95% of the third second (ZVK3) is expired. Practical and important test for the evaluation of obstructive abnormality ZVKl particular, decreases in parallel with an increase in obstructive abnormality. FVC and maximal expiratory flow curve measured maximal mid-expiratory flow the other tests used to assess respiratory mechanics.
Maximal expiratory flow-volume curves (MEAV), forced vital capacity as measured by these tests, ie, after a maximal inspiration and maximal expiration flow-volume relationship evaluated quickly. Especially maximal expiratory flow curve MEAV (Vmax) and the measured flow in the middle of FVC (V50) evaluation of obstructive and restrictive abnormalities practical dimensions. Normally, about 8L/saniye Vmax, approximately 4L/sa-niyedir V50. Normal size increases with Vmax and V50, decreases with increasing age.
FVC, and bronchodilator MEAV curves measured before and after treatment of obstructive amormaliğin lürse improvement is evaluated. Disease diagnosis and detection of curves in progmozunun MEAV FVC and pulmonary function tests.
Inspiration and expiration of air entering or exiting the factors that facilitate or complicate related to respiratory mechanics. These factors are collected in 3 groups: 1 The flexibility of the lungs, 2 bronşiyoUerde bronchus and air flow resistance, 3 frictional resistance changed the shape of the thorax and lung tissues.
A test that measures lung compliance flexibility. Shows the relationship between pressure and volume changes. Normally, lung compliance is 0.2 L/smH20. Reduction in water pressure in the lungs and pleura in other words, one part expands 0.2 liter (0.2 liters of air into the lungs) or the increase in pleural pressure in the lungs, a portion of water shrinks 0.2 liter (0.2 liter air out the lungs). Compliance is less than the decreased flexibility of the lungs (fibrosis, silicosis, mitral stenosis).
Airways resistance assessed by measuring the relationship between air flow and pressure. Normally, airway resistance H20/L/sani-yedir 1.6 sm. In other words, a second input or output of 1 liter of air breathing ways to be a force for the 1.6 portion of water pressure. Respiratory resistance emphysema, asthma, obstructive diseases, such as increases. Tests that measure pulmonary mechanics is done in laboratories with sophisticated organized and well-trained professionals. Therefore, these tests can be measured more easily and instead of showing the change of respiratory mechanics impairment tests in parallel, for example, forced vital capacity, maximal expiratory flow-volume curves, maximal respiratory capacity is used.
Forced vital capacity (FVC), forced vital capacity at this time is called. Vital capacity is done as fast as possible. FVC test examined the relationship between volume and time. Normally ZVK'nın 75% in one second (ZVKl), 85% second per second (ZVK2) and 95% of the third second (ZVK3) is expired. Practical and important test for the evaluation of obstructive abnormality ZVKl particular, decreases in parallel with an increase in obstructive abnormality. FVC and maximal expiratory flow curve measured maximal mid-expiratory flow the other tests used to assess respiratory mechanics.
Maximal expiratory flow-volume curves (MEAV), forced vital capacity as measured by these tests, ie, after a maximal inspiration and maximal expiration flow-volume relationship evaluated quickly. Especially maximal expiratory flow curve MEAV (Vmax) and the measured flow in the middle of FVC (V50) evaluation of obstructive and restrictive abnormalities practical dimensions. Normally, about 8L/saniye Vmax, approximately 4L/sa-niyedir V50. Normal size increases with Vmax and V50, decreases with increasing age.
FVC, and bronchodilator MEAV curves measured before and after treatment of obstructive amormaliğin lürse improvement is evaluated. Disease diagnosis and detection of curves in progmozunun MEAV FVC and pulmonary function tests.
Vital Lung Capacity Test Lung Volume
Lung Test, Pulmonary Function Tests
Lung function tests, respiratory system diseases, especially niteliğindedir routine investigations. The main indications: evaluation of disease diagnosis and prognosis are important contributions. And to decide whether surgery is required.
Lung function tests can be examined in 3 groups:
1. Lung volumes
2. Respiratory mechanics
3. Gas exchange (ventilation, diffusion, perfusion, and arterial blood gases)
1. Lung volumes, lung volume
Measured statically. Main:
Vital Capacity (VC), maximal inspiration after a maximal forced expiratory volume in air. Middle-aged and mid-size a normal person's vital capacity is approximately 4500 ml.
Residual Volume (RV), maximal at the end of an expiratory volume of air remaining in the lungs. Normally, about 1000 ml.dır. Increases with age. Chronic obstructive pulmonary diseases (emphysema, asthma and chronic bronchitis), and it increases with increasing residual volume and total lung capacity ratio (RV / TAC) increases. RV / TAK 's growth is an important finding for obstructive lung diseases.
Total lung capacity (TAC), maximal inspiratory gas present in the lung at the end. TAC = VC + RV volümüdür. About 5-8 liters.
Tidal volume (TV) in the inspiratory or expiratory volume during respiration. 500-800 ml.dir rest.
TAC = total lung capacity, TV = Tidal volume, HR = inspiratory capacity, FRC = functional residual capacity, expiratory reserve EY =, VC = vital capacity, RV = residual volume.
Vital capacity is one of the most commonly used lung function tests. Vital capacity decreased major diseases:
Parenkinıa Lung Diseases: Common fibrosis, tuberculosis, tumors, atelectasis, surgery.
Thoracic restriction of movements: Obesity, rib fractures, kifos-Spanish mackerel, poliomyelitis, myasthenia gravis.
Restriction of lung expansion capacity of pleural effusion, pneumonia-a pneumothorax, diaphragmatic hernia, fibrothorax, heart growth.
Obstruction of the airways: asthma, emphysema, bronchial stenosis.
Lung function tests, respiratory system diseases, especially niteliğindedir routine investigations. The main indications: evaluation of disease diagnosis and prognosis are important contributions. And to decide whether surgery is required.
Lung function tests can be examined in 3 groups:
1. Lung volumes
2. Respiratory mechanics
3. Gas exchange (ventilation, diffusion, perfusion, and arterial blood gases)
1. Lung volumes, lung volume
Measured statically. Main:
Vital Capacity (VC), maximal inspiration after a maximal forced expiratory volume in air. Middle-aged and mid-size a normal person's vital capacity is approximately 4500 ml.
Residual Volume (RV), maximal at the end of an expiratory volume of air remaining in the lungs. Normally, about 1000 ml.dır. Increases with age. Chronic obstructive pulmonary diseases (emphysema, asthma and chronic bronchitis), and it increases with increasing residual volume and total lung capacity ratio (RV / TAC) increases. RV / TAK 's growth is an important finding for obstructive lung diseases.
Total lung capacity (TAC), maximal inspiratory gas present in the lung at the end. TAC = VC + RV volümüdür. About 5-8 liters.
Tidal volume (TV) in the inspiratory or expiratory volume during respiration. 500-800 ml.dir rest.
TAC = total lung capacity, TV = Tidal volume, HR = inspiratory capacity, FRC = functional residual capacity, expiratory reserve EY =, VC = vital capacity, RV = residual volume.
Vital capacity is one of the most commonly used lung function tests. Vital capacity decreased major diseases:
Parenkinıa Lung Diseases: Common fibrosis, tuberculosis, tumors, atelectasis, surgery.
Thoracic restriction of movements: Obesity, rib fractures, kifos-Spanish mackerel, poliomyelitis, myasthenia gravis.
Restriction of lung expansion capacity of pleural effusion, pneumonia-a pneumothorax, diaphragmatic hernia, fibrothorax, heart growth.
Obstruction of the airways: asthma, emphysema, bronchial stenosis.
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