Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Introduction
- Classification of Devices
- Fixed-Performance Devices
- Variable Performance Devices
- Introduction: The 4th National Audit Project
- Anatomy
- Approaches
- Difficult Airway Society’s Recommended Technique
- Introduction: NAP4
- How to Predict an Anatomically Difficult Airway
- Equipment
- Difficult Airway Society Guidelines and Airway Management in Critically Ill Adults
- Tracheostomy difficulties
- Introduction
- Indications for Bronchoscopy in the ICU
- Contraindications
- Procedure
- Complications
- Conclusion
- Introduction
- Pre-procedural Considerations
- Procedure
- Post-procedure
- Acknowledgements
- Introduction
- Indications
- Contraindications (Relative)
- Technique for Insertion
- Drainage Bottles
- Pneumothorax Management
- Analysis of Fluid
- Complications
- Introduction
- Diagnosis of Acute Respiratory Failure
- Ultrasound in the Role of Weaning from Mechanical Ventilation
- Pleural Effusions
- Distinguishing Atelectasis from Pneumonia
- Ultrasound to Distinguish ARDS from Cardiac Pulmonary Oedema
- Introduction
- Spirometry
- Inspiratory and Expiratory Flow–Volume Loops in Upper Airway Obstruction
- Bronchodilator Response and Reversibility
- Lung Volumes
- Disease Patterns
- Gas Transfer
- Indications
- Contraindications to Line Insertion
- Risks/Complications
- Potential Insertion Sites
- Allen’s Test
- Procedure
- Introduction
- Localisation of Vasculature
- Techniques for Ultrasound-Guided Peripheral Vascular Access
- Introduction
- Indications
- Contraindications
- Complications
- Ultrasound
- Sites
- Procedure
- Confirmation of Line Placement
- Arterial Puncture
- Introduction
- Equipment Components
- Procedure
- Interpretation
- Clinical Use of Pulmonary Artery Catheters
- Complications
- Introduction
- Pad Positions
- Defibrillation
- Summary of Defibrillation Protocol in Advanced Life Support
- Optimising Defibrillation
- Oxygen
- Drugs in Defibrillation
- Energy Levels
- Implantable Cardioverter–Defibrillators
- Cardioversion outside the Cardiac Arrest Situation
- Complications
- Introduction
- Temporary
- Permanent Transvenous
- Miscellaneous
- Basic Pacing Concepts – Sensing and Capture
- Modes of Operation
- Management of Temporary Systems in the ICU
- Management of Permanent Systems in the ICU
- Pathophysiology of Cardiac Tamponade
- Aetiology of Pericardial Effusion
- Diagnosis
- Indications for Pericardiocentesis
- Contraindications of Pericardiocentesis
- Procedure
- Complications of Pericardiocentesis
- Introduction
- Pulmonary Artery Catheters
- Transoesophageal Echocardiography
- Doppler Devices
- Pulse Pressure Analysis
- Non-invasive Techniques
- Research Tools
- Introduction
- Lead placement and FICE views
- The Essence of FICE
- Common Pathologies Identified
- Acknowledgements
- Introduction
- Indications
- Contraindications
- Lumbar Punctures in the Emergency Setting
- Equipment and Technique
- Samples to Send
- Interpreting Results in Suspected Meningitis
- Complications
- Introduction
- Indications
- Anatomy, Physiology and Pharmacology
- Epidural Regimes
- Assessment and Monitoring
- Troubleshooting
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Volume Replacement
- Analysis of Fluid
- Complications
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Aftercare
- Complications
- Introduction
- Indications
- Contraindications
- Risks/Complications
- Procedure
- Additional Points
- Section 5.1 Practical Respiratory System
- 5.1.1 Oxygen Administration in Intensive Care
- 5.1.2 Emergency Front of Neck Airway Management
- 5.1.3 Difficult Intubation Guidelines and Failed Airway Management
- 5.1.4 Principles of Performing Fibreoptic Bronchoscopy and Broncho-alveolar Lavage in the Intubated Patient
- 5.1.5 Percutaneous Tracheostomies and Management of Tracheostomy Emergencies
- 5.1.6 Chest Drain Insertion
- 5.1.7 Lung Ultrasound
- 5.1.8 Lung Function Testing
- Section 5.2 Practical Cardiovascular System
- Section 5.3 Practical Central Nervous System
- Section 5.4 Practical Gastrointestinal System
- Section 5.5 Practical Genitourinary System
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
5.1.8 - Lung Function Testing
from Section 5.1 - Practical Respiratory System
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Introduction
- Classification of Devices
- Fixed-Performance Devices
- Variable Performance Devices
- Introduction: The 4th National Audit Project
- Anatomy
- Approaches
- Difficult Airway Society’s Recommended Technique
- Introduction: NAP4
- How to Predict an Anatomically Difficult Airway
- Equipment
- Difficult Airway Society Guidelines and Airway Management in Critically Ill Adults
- Tracheostomy difficulties
- Introduction
- Indications for Bronchoscopy in the ICU
- Contraindications
- Procedure
- Complications
- Conclusion
- Introduction
- Pre-procedural Considerations
- Procedure
- Post-procedure
- Acknowledgements
- Introduction
- Indications
- Contraindications (Relative)
- Technique for Insertion
- Drainage Bottles
- Pneumothorax Management
- Analysis of Fluid
- Complications
- Introduction
- Diagnosis of Acute Respiratory Failure
- Ultrasound in the Role of Weaning from Mechanical Ventilation
- Pleural Effusions
- Distinguishing Atelectasis from Pneumonia
- Ultrasound to Distinguish ARDS from Cardiac Pulmonary Oedema
- Introduction
- Spirometry
- Inspiratory and Expiratory Flow–Volume Loops in Upper Airway Obstruction
- Bronchodilator Response and Reversibility
- Lung Volumes
- Disease Patterns
- Gas Transfer
- Indications
- Contraindications to Line Insertion
- Risks/Complications
- Potential Insertion Sites
- Allen’s Test
- Procedure
- Introduction
- Localisation of Vasculature
- Techniques for Ultrasound-Guided Peripheral Vascular Access
- Introduction
- Indications
- Contraindications
- Complications
- Ultrasound
- Sites
- Procedure
- Confirmation of Line Placement
- Arterial Puncture
- Introduction
- Equipment Components
- Procedure
- Interpretation
- Clinical Use of Pulmonary Artery Catheters
- Complications
- Introduction
- Pad Positions
- Defibrillation
- Summary of Defibrillation Protocol in Advanced Life Support
- Optimising Defibrillation
- Oxygen
- Drugs in Defibrillation
- Energy Levels
- Implantable Cardioverter–Defibrillators
- Cardioversion outside the Cardiac Arrest Situation
- Complications
- Introduction
- Temporary
- Permanent Transvenous
- Miscellaneous
- Basic Pacing Concepts – Sensing and Capture
- Modes of Operation
- Management of Temporary Systems in the ICU
- Management of Permanent Systems in the ICU
- Pathophysiology of Cardiac Tamponade
- Aetiology of Pericardial Effusion
- Diagnosis
- Indications for Pericardiocentesis
- Contraindications of Pericardiocentesis
- Procedure
- Complications of Pericardiocentesis
- Introduction
- Pulmonary Artery Catheters
- Transoesophageal Echocardiography
- Doppler Devices
- Pulse Pressure Analysis
- Non-invasive Techniques
- Research Tools
- Introduction
- Lead placement and FICE views
- The Essence of FICE
- Common Pathologies Identified
- Acknowledgements
- Introduction
- Indications
- Contraindications
- Lumbar Punctures in the Emergency Setting
- Equipment and Technique
- Samples to Send
- Interpreting Results in Suspected Meningitis
- Complications
- Introduction
- Indications
- Anatomy, Physiology and Pharmacology
- Epidural Regimes
- Assessment and Monitoring
- Troubleshooting
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Volume Replacement
- Analysis of Fluid
- Complications
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Aftercare
- Complications
- Introduction
- Indications
- Contraindications
- Risks/Complications
- Procedure
- Additional Points
- Section 5.1 Practical Respiratory System
- 5.1.1 Oxygen Administration in Intensive Care
- 5.1.2 Emergency Front of Neck Airway Management
- 5.1.3 Difficult Intubation Guidelines and Failed Airway Management
- 5.1.4 Principles of Performing Fibreoptic Bronchoscopy and Broncho-alveolar Lavage in the Intubated Patient
- 5.1.5 Percutaneous Tracheostomies and Management of Tracheostomy Emergencies
- 5.1.6 Chest Drain Insertion
- 5.1.7 Lung Ultrasound
- 5.1.8 Lung Function Testing
- Section 5.2 Practical Cardiovascular System
- Section 5.3 Practical Central Nervous System
- Section 5.4 Practical Gastrointestinal System
- Section 5.5 Practical Genitourinary System
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Lung function testing is important in the diagnosis, severity assessment and monitoring of lung diseases.
2. Spirometry measures forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio. Its uses include: screening for airflow limitation, assessing disease progression and diagnostic purposes (in combination with further lung function testing).
3. Lung volume measurements provide additional information to help differentiate restrictive, obstructive and mixed lung diseases.
4. Transfer factor for carbon monoxide (TLCO) (diffusion capacity of carbon monoxide (DLCO)) measures the ability of the lungs to transfer inhaled gas from the alveoli to red blood cells in the pulmonary capillaries. It can be used alongside the carbon monoxide transfer coefficient (KCO) for diagnostic purposes and to monitor disease progression.
5. Lung function testing is subject to a number of limitations and, as such, should be interpreted with flow–volume loops and clinical context.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 555 - 560Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Cooper, BG. An update on contraindications for lung function testing. Thorax 2011;66:714–23.CrossRefGoogle ScholarPubMed
Miller, MR, Hankinson, J, Brusasko, V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319–38.CrossRefGoogle ScholarPubMed
Pellegrino, R, Viegi, G, Brusasco, V, et al. Interpretive strategies for lung function tests. Eur Respir J 2005;26:948–68.Google Scholar
Shiner, RJ, Steier, J. Lung Function Tests Made Easy. Edinburgh: Elsevier/Churchill Livingstone; 2013.Google Scholar