Diagnosis Of Lung Conditions With A Spirometer

By Jaclyn Hurley


One of the most common tests for measuring lung function is the use of a spirometer. This is a device that measures the speed and volume of air inspired and expired by a person's lungs. Spirometry is used to assess conditions such as chronic obstructive pulmonary disorder (COPD), asthma, cystic fibrosis and pulmonary fibrosis. It is able to distinguish between two types of abnormal respiratory pattern, obstructive and restrictive. There are several types of spirometers in use and they have been evolving since the first century AD.

Restrictive lung disease (RLD) impedes the expansion of the lungs on inspiration. This results in a decreased lung volume, forcing the individual to work harder to draw breath. Both ventilation and oxygenation are impaired. Pulmonary fibrosis, or scarring of the lung is one condition underlying RLD. The normal lung parenchyma becomes interspersed with scar tissue, resulting in a honeycomb appearance. Thankfully rare, pulmonary fibrosis is poorly understood, worsens over time and is often fatal.

Other disorders that fall under the umbrella of RLD include the autoimmune condition, sarcoidosis; myscular dystrophy, amyotrophic lateral sclerosis (ALS), and obesity. Most patients present initially with difficulty breathing. Sarcoidosis is recognized by red, swollen lesions known as granulomas, mostly affecting the lungs and the skin. Some patients may suddenly develop symptoms that disappear spontaneously. Other people may never know they have sarcoidosis until they have an x-ray for another condition.

Obstructive lung disorders (OLD) are diagnosed by the presence of obstructed and inflamed airways. Airflow is obstructed and the patient experiences difficulty breathing out. OLDs are are responsible for frequent trips to the hospital. Diseases which fall into the category of obstructive lung disorders include asthma, COPD and bronchitis. One thing these individuals have in common is inability to expire 70% of breath within a one-second time interval.

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.

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 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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