Additional Information
Book Details
Abstract
Use this authoritative guide as an on-the-job reference — and to prepare for the CPFT and RPFT credentialing examinations! Ruppel's Manual of Pulmonary Function Testing, 11th Edition provides comprehensive coverage of common pulmonary function tests, testing techniques, and the pathophysiology that may be evaluated by each test. It also includes information on equipment, computers, and quality assurance, so you can develop the testing skills you need to find and assess lung abnormalities and conditions including asthma, COPD, emphysema, and cystic fibrosis. Written by Carl Mottram, a well-known expert in pulmonary function procedures, this bestselling guide helps you get accurate test results every time.
- Entry- and Advanced-Level objectives prepare you for success on the Certified Pulmonary Function Technologist and Registered Pulmonary Function Technologist credentialing examinations, and follow the content guidelines suggested by the CPFT and RPFT exam matrices from the National Board for Respiratory Care (NBRC).
- How To boxes provide step-by-step guidelines to performing pulmonary function tests, taking the guesswork out of completing accurate and result-producing tests.
- PFT Tips highlight and reinforce the most important Pulmonary Function Testing information in every chapter.
- Case studies provide problem-solving challenges for common clinical cases, including each case history, PFT testing results, a technologist’s comments, and questions and answers.
- Convenient study features include key terms, chapter outlines, learning objectives, suggested readings, a glossary, and self-assessment questions.
- Authoritative, comprehensive resource conveys state-of-the-art information, and eliminates the need to search for information in other sources.
- Criteria for acceptability and repeatability are included in each test section, as well as interpretive strategies to help you adhere to recognized testing standards.
- NEW! UPDATED content reflects the latest guidelines, testing procedure recommendations, and interpretive strategies of the American Thoracic Society/European Respiratory Society as well as the newest guidelines for exercise testing from the American Thoracic Society/American College of Chest Physicians.
- NEW! Practice tests on the Evolve companion website help you apply the knowledge learned in the text.
- NEW! Summary Points at the end of chapters reinforce important entry-level and advanced-level concepts.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Ruppel’s manual of Pulmonary Function Testing | iii | ||
| Copyright | iv | ||
| Contributors/Reviewers | v | ||
| Foreword | vi | ||
| Preface | vii | ||
| Distinctive features | vii | ||
| Changes to this edition | viii | ||
| Using this book | viii | ||
| Evolve ancillaries | viii | ||
| Acknowledgments | ix | ||
| Contents | x | ||
| Chapter 1: Indications for Pulmonary Function Testing | 1 | ||
| Pulmonary function tests | 2 | ||
| Airway Function Tests | 2 | ||
| Lung Volume and Ventilation Tests | 5 | ||
| Diffusing Capacity Tests | 5 | ||
| Blood Gases and Gas Exchange Tests | 6 | ||
| Cardiopulmonary Exercise Tests | 6 | ||
| Metabolic Measurements | 7 | ||
| Indications for pulmonary function testing | 7 | ||
| Spirometry | 7 | ||
| Lung Volumes | 8 | ||
| Diffusing Capacity | 8 | ||
| Blood Gases | 9 | ||
| Exercise Tests | 10 | ||
| Patterns of impaired pulmonary function | 10 | ||
| Obstructive Airway Diseases | 10 | ||
| Chronic Obstructive Pulmonary Disease | 10 | ||
| Emphysema | 11 | ||
| Chronic Bronchitis | 12 | ||
| Bronchiectasis | 13 | ||
| Management of Chronic Obstructive Pulmonary Disease | 14 | ||
| Hyperreactive Airway Disease: Asthma | 15 | ||
| Management of Asthma | 16 | ||
| Cystic Fibrosis | 17 | ||
| Management of Cystic Fibrosis | 18 | ||
| Upper or Large Airway Obstruction | 18 | ||
| Management of Upper or Large Airway Obstruction | 19 | ||
| Restrictive Lung Disease | 19 | ||
| Pulmonary Fibrosis | 20 | ||
| Pneumoconioses | 20 | ||
| Sarcoidosis | 21 | ||
| Diseases of the Chest Wall and Pleura | 22 | ||
| Neuromuscular Disorders | 23 | ||
| Congestive Heart Failure | 24 | ||
| Lung Transplantation | 25 | ||
| Preliminaries to patient testing | 26 | ||
| Before Patient Testing | 26 | ||
| The Twelve QSEs | 26 | ||
| Patient Preparation (Pre-Test Instructions) | 27 | ||
| Withholding Medications | 27 | ||
| Smoking Cessation | 28 | ||
| Other Patient Preparation Issues | 28 | ||
| Anthropometric Measurements | 29 | ||
| Physical Assessment | 29 | ||
| Pulmonary History | 32 | ||
| Test performance and sequence | 32 | ||
| Technologist-Driven Protocols | 33 | ||
| Patient Instruction | 34 | ||
| Summary | 35 | ||
| Case study | 35 | ||
| General References | 37 | ||
| Indications for Pulmonary Function Testing | 37 | ||
| Patterns of Impaired Pulmonary Function | 38 | ||
| Preliminaries to Patient Testing | 38 | ||
| Chapter 2: Spirometry | 39 | ||
| Vital capacity | 40 | ||
| Description | 40 | ||
| Technique | 41 | ||
| Significance and Pathophysiology | 41 | ||
| Forced vital capacity, forced expiratory volume, and forced expiratory flow | 43 | ||
| Description | 43 | ||
| Technique | 44 | ||
| Acceptability and Repeatability for Spirometry Results | 48 | ||
| Significance and Pathophysiology | 49 | ||
| Forced Vital Capacity | 49 | ||
| Forced Expiratory Volume | 51 | ||
| Forced Expiratory Volume Ratio | 52 | ||
| Forced Expiratory Flow 25%–75% | 53 | ||
| Flow-volume curve | 54 | ||
| Description | 54 | ||
| Technique | 55 | ||
| Significance and Pathophysiology | 56 | ||
| Flow-Volume Loops in Small Airway Obstruction | 59 | ||
| Flow-Volume Loops in Large Airway Obstruction | 59 | ||
| Flow-Volume Loops in Restrictive Disease | 60 | ||
| Peak expiratory flow | 63 | ||
| Description | 63 | ||
| Technique | 63 | ||
| Significance and Pathophysiology | 64 | ||
| Maximum voluntary ventilation | 65 | ||
| Description | 65 | ||
| Technique | 65 | ||
| Significance and Pathophysiology | 66 | ||
| Before- and after-bronchodilator studies | 67 | ||
| Description | 67 | ||
| Technique | 67 | ||
| Significance and Pathophysiology | 69 | ||
| Summary | 70 | ||
| Case studies | 70 | ||
| Entry-level | 75 | ||
| Advanced | 77 | ||
| General References | 77 | ||
| Spirometry | 77 | ||
| Peak Expiratory Flow | 78 | ||
| Before- and After-Bronchodilator Studies | 78 | ||
| Flow-Volume Curves | 79 | ||
| Standards and Guidelines | 79 | ||
| Chapter 3: Diffusing Capacity Tests | 80 | ||
| Carbon monoxide diffusing capacity | 81 | ||
| Description | 81 | ||
| Techniques | 81 | ||
| Single Breath-Hold Technique (Modified Krogh’s Technique) | 82 | ||
| Rebreathing Technique | 89 | ||
| Slow Exhalation Single-Breath Intrabreath Method | 89 | ||
| Membrane Diffusion Coefficient and Capillary Blood Volume | 90 | ||
| Significance and Pathophysiology | 90 | ||
| Summary | 97 | ||
| Case studies | 97 | ||
| Entry-level | 101 | ||
| Advanced | 102 | ||
| Selected bibliography | 102 | ||
| General References | 102 | ||
| Dlcosb | 103 | ||
| Dlcorb | 103 | ||
| Dlcoib | 103 | ||
| Standards and Guidelines | 103 | ||
| Chapter 4: Lung Volumes, Airway Resistance, and Gas Distribution Tests | 104 | ||
| Lung volumes: functional residual capacity, residual volume, total lung capacity, and residual volume/total lung capacity ... | 105 | ||
| Description | 105 | ||
| Technique | 105 | ||
| Open-Circuit, Multiple-Breath Nitrogen Washout | 105 | ||
| Closed-Circuit, Multiple-Breath Helium Dilution | 109 | ||
| Correcting for the “Switch-In” Error | 111 | ||
| Additional Comments on FRC by Gas Dilution Techniques | 111 | ||
| Body Plethysmography | 112 | ||
| Additional Comments on FRC by Plethysmography | 116 | ||
| Total Lung Capacity and Residual Volume/Total Lung Capacity Ratio | 117 | ||
| Significance and Pathophysiology | 117 | ||
| Airway resistance and conductance | 120 | ||
| Description | 120 | ||
| Technique | 120 | ||
| Significance and Pathophysiology | 123 | ||
| Gas distribution tests: single-breath nitrogen washout, closing volume, and closing capacity | 125 | ||
| Description | 125 | ||
| Technique | 125 | ||
| Significance and Pathophysiology | 126 | ||
| Δ%N2 750–1250 | 126 | ||
| Slope of Phase III | 126 | ||
| Closing Volume and Closing Capacity | 127 | ||
| Multiple Breath nitrogen washout, lung clearance index, and phase III slope analysis | 128 | ||
| Description | 128 | ||
| Technique | 128 | ||
| Significance and Pathophysiology | 128 | ||
| Summary | 128 | ||
| Case studies | 129 | ||
| Entry-level | 135 | ||
| General References | 137 | ||
| Spirometry and Lung Volumes | 137 | ||
| Thoracic Gas Volume | 137 | ||
| Airway Resistance | 137 | ||
| Gas Dilution Lung Volumes | 137 | ||
| Gas Distribution | 138 | ||
| Standards and Guidelines | 138 | ||
| Chapter 5: Ventilation and Ventilatory Control Tests | 139 | ||
| Tidal volume, rate, and minute ventilation | 140 | ||
| Description | 140 | ||
| Technique | 140 | ||
| Significance and Pathophysiology | 141 | ||
| Respiratory dead space and alveolar ventilation | 142 | ||
| Description | 142 | ||
| Technique | 143 | ||
| Dead Space | 143 | ||
| Alveolar Ventilation | 143 | ||
| Significance and Pathophysiology | 144 | ||
| Ventilatory response tests for carbon dioxide and oxygen | 145 | ||
| Description | 145 | ||
| Technique | 145 | ||
| Significance and Pathophysiology | 147 | ||
| High-altitude simulation test | 149 | ||
| Description | 149 | ||
| Technique | 149 | ||
| Significance and Pathophysiology | 151 | ||
| Summary | 152 | ||
| Case studies | 153 | ||
| Entry-level | 156 | ||
| Advanced | 156 | ||
| General References | 157 | ||
| Ventilation | 157 | ||
| Control of Ventilation | 157 | ||
| High-Altitude Simulation Test (or Hypoxic Inhalation Test) | 158 | ||
| Chapter 6: Blood Gases and Related Tests | 159 | ||
| Chapter 7: Cardiopulmonary Exercise Testing and Field Tests | 190 | ||
| Field tests | 192 | ||
| Six-minute walk test (6mwt) reference set | 194 | ||
| Exercise protocols | 195 | ||
| Exercise workload | 196 | ||
| Cardiovascular monitors during exercise | 200 | ||
| Heart Rate and Electrocardiogram | 200 | ||
| Blood Pressure | 203 | ||
| Safety | 205 | ||
| Ventilation during exercise | 206 | ||
| Equipment Selection and Calibration | 206 | ||
| Minute Ventilation | 208 | ||
| Tidal Volume and Respiratory Rate | 209 | ||
| Flow-Volume Loop Analysis | 212 | ||
| Oxygen consumption, carbon dioxide production, and respiratory exchange ratio during exercise | 213 | ||
| Oxygen Consumption | 213 | ||
| Carbon Dioxide Production | 215 | ||
| Respiratory Exchange Ratio | 215 | ||
| Anaerobic or Ventilatory Threshold | 216 | ||
| Ventilatory Equivalent for Oxygen | 217 | ||
| Ventilatory Equivalent for Carbon Dioxide | 218 | ||
| Oxygen Pulse | 218 | ||
| Exercise blood gases | 219 | ||
| Arterial Catheterization | 219 | ||
| Arterial Puncture | 219 | ||
| Pulse Oximetry | 220 | ||
| Arterial Oxygen Tension During Exercise | 220 | ||
| Arterial Carbon Dioxide Tension During Exercise | 221 | ||
| Acid-Base Status During Exercise | 222 | ||
| Exercise Variables Calculated from Blood Gases | 222 | ||
| Cardiac output during exercise | 223 | ||
| Noninvasive Cardiac Output Techniques | 223 | ||
| Direct Fick Method | 224 | ||
| Thermodilution Method | 224 | ||
| Cardiac Output During Exercise | 224 | ||
| Symptoms Scales | 225 | ||
| Quality of Test | 226 | ||
| Interpretation Strategies | 226 | ||
| Summary | 227 | ||
| Case studies | 228 | ||
| Entry-level | 240 | ||
| Advanced | 240 | ||
| General References | 242 | ||
| Six-Minute Walk Test | 242 | ||
| Cardiovascular Monitoring During Exercise | 242 | ||
| Ventilation, Gas Exchange, and Blood Gases | 242 | ||
| Standards and Guidelines | 242 | ||
| Chapter 8: Pediatric Pulmonary Function Testing | 244 | ||
| Infant, toddler, and preschool pulmonary function testing | 246 | ||
| Purpose of Pulmonary Function Tests for Infants and Toddlers | 246 | ||
| Performance of Pulmonary Function Testing in Infants and Toddlers | 247 | ||
| Sedation as an Important Consideration | 247 | ||
| When Children Are Too Old for Infant-Style Testing and Too Young for Standard Testing | 248 | ||
| Lung Volume Measurement | 248 | ||
| Passive Tidal Techniques to Measure Respiratory Mechanics | 250 | ||
| Passive Tidal Loops | 250 | ||
| Passive Compliance, Resistance, and Time Constants | 250 | ||
| Thoracoabdominal Motion Analysis | 252 | ||
| Additional Passive Techniques Available to Measure in the Preschool Child | 255 | ||
| Impulse Oscillometry | 255 | ||
| Interrupter Technique (Rint) | 256 | ||
| Exhaled Nitric Oxide and Nasal Nitric Oxide | 258 | ||
| Forced Flow Techniques for Infants, Toddlers, and Preschool Children | 259 | ||
| Partial Expiratory Flow-Volume Curves | 259 | ||
| Forced Flows from Raised Lung Volume | 261 | ||
| Forced Deflation Technique | 262 | ||
| Spirometry | 263 | ||
| Age Considerations for Children Performing Spirometry | 263 | ||
| Ensuring Maximal Effort on the Part of the Child | 264 | ||
| Importance of Effort | 267 | ||
| Length of Exhalation for a Child During an FVC Maneuver | 269 | ||
| Reliability of FEF25%–75% in Children | 271 | ||
| Parameters of Inspiratory Forced Flow Helpful in Pediatrics | 271 | ||
| Role of Vocal Cord Dysfunction | 272 | ||
| VCD Combined with Intrathoracic Airflow Obstruction | 274 | ||
| Nonrepeatability in the Expiratory Maneuver | 275 | ||
| Airway Malacia | 275 | ||
| Diffusion capacity | 276 | ||
| Other Measured and Clinically Followed Parameters of Pulmonary Function in Pediatrics | 278 | ||
| Maximal Respiratory Pressures | 278 | ||
| Maximal Voluntary Ventilation | 281 | ||
| Arterial Blood Gases | 281 | ||
| Lung volumes | 281 | ||
| First Step | 282 | ||
| Important Plethysmographic Parameters | 282 | ||
| Role of Measurement of Airway Resistance | 283 | ||
| Bronchoprovocation challenges | 283 | ||
| Pulmonary Exercise Stress Testing | 285 | ||
| Exhaled nitric oxide standards for testing | 287 | ||
| Variability in Reference Sets and Predicted Values for Pediatrics | 288 | ||
| What the future holds for pediatric pulmonary function laboratories | 290 | ||
| Summary | 291 | ||
| Case studies | 291 | ||
| General References | 300 | ||
| Spirometry | 300 | ||
| Predicted Values and Reference Equations | 300 | ||
| Vocal Cord Dysfunction and Obstructing Upper Airway Lesions | 301 | ||
| Exercise Stress Testing | 301 | ||
| Pulmonary Function Testing in Infants and Very Young Children | 301 | ||
| Oscillometry and Nitric Oxide | 302 | ||
| Standards and Guidelines | 303 | ||
| Chapter 9: Bronchoprovocation Challenge Testing | 304 | ||
| Bronchoprovocation challenge testing | 305 | ||
| Methacholine Challenge | 306 | ||
| Five-Breath Dosimeter Method | 310 | ||
| 2-Minute Tidal Breathing Method | 310 | ||
| Histamine Challenge | 314 | ||
| Mannitol Challenge | 315 | ||
| Exercise Challenge | 317 | ||
| Eucapnic Voluntary Hyperventilation | 320 | ||
| Summary | 323 | ||
| Case studies | 323 | ||
| Entry-level | 326 | ||
| Advanced | 327 | ||
| Bronchial Challenge | 328 | ||
| Guidelines and Standards | 328 | ||
| Chapter 10: Specialized Test Regimens | 329 | ||
| Respiratory muscle strength testing | 330 | ||
| Description | 330 | ||
| Technique | 330 | ||
| Significance and Pathophysiology | 332 | ||
| Exhaled nitric oxide | 333 | ||
| Description | 333 | ||
| Techniques | 334 | ||
| Online FeNO in Adults | 334 | ||
| Offline FeNO in Adults | 335 | ||
| Nasal Nitric Oxide | 336 | ||
| Significance and Pathophysiology | 336 | ||
| Forced oscillation technique | 338 | ||
| Preoperative pulmonary function testing | 341 | ||
| Spirometry | 342 | ||
| Bronchodilator Studies | 342 | ||
| Blood Gas Analysis | 342 | ||
| Exercise Testing | 342 | ||
| Diffusing Capacity (Dlco) | 342 | ||
| Perfusion and Scans | 342 | ||
| Pulmonary Artery Occlusion Pressure | 343 | ||
| Pulmonary function testing for social security disability | 343 | ||
| Forced Vital Capacity and Forced Expiratory Volume | 344 | ||
| Diffusing Capacity | 345 | ||
| Arterial Blood Gases | 346 | ||
| Exercise Testing | 346 | ||
| Metabolic measurements: indirect calorimetry | 347 | ||
| Description | 347 | ||
| Techniques | 347 | ||
| Open-Circuit Calorimetry | 347 | ||
| Closed-Circuit Calorimetry | 348 | ||
| Performing Metabolic Measurements | 348 | ||
| Metabolic Calculations | 350 | ||
| Significance and Pathophysiology | 352 | ||
| Summary | 354 | ||
| Case studies | 354 | ||
| Entry-level | 359 | ||
| Advanced | 359 | ||
| Respiratory Muscle Strength Testing | 360 | ||
| Exhaled Nitric Oxide | 360 | ||
| Forced Oscillation Technique | 360 | ||
| Preoperative Pulmonary Function Testing | 361 | ||
| Respiratory Impairment for Disability | 361 | ||
| Metabolic Measurements: Indirect Calorimetry | 361 | ||
| Guidelines and Standards | 362 | ||
| Chapter 11: Pulmonary Function Testing Equipment | 363 | ||
| Volume-displacement spirometers | 364 | ||
| Water-Seal Spirometers | 364 | ||
| Dry Rolling Seal Spirometers | 367 | ||
| Bellows-Type Spirometers | 368 | ||
| Flow-sensing spirometers | 369 | ||
| Turbines | 370 | ||
| Pressure Differential Flow Sensors | 371 | ||
| Heated-Wire Flow Sensors | 373 | ||
| Pitot Tube Flow Sensors | 374 | ||
| Ultrasonic Flow Sensors | 374 | ||
| Flow Sensor Summary | 375 | ||
| Portable (Office) Spirometers | 376 | ||
| Peak flowmeters | 379 | ||
| Body plethysmographs | 380 | ||
| Pressure Plethysmographs | 380 | ||
| Flow Plethysmographs | 380 | ||
| Breathing valves | 384 | ||
| Free Breathing and Demand Valves | 384 | ||
| Directional Valves | 385 | ||
| Gas-Sampling Valves | 386 | ||
| Pulmonary gas analyzers | 387 | ||
| Oxygen Analyzers | 387 | ||
| Polarographic Electrodes | 387 | ||
| Zirconium Fuel Cells | 388 | ||
| Infrared Absorption (CO2, CO) Analyzers | 388 | ||
| Emission Spectroscopy Analyzers | 390 | ||
| Thermal Conductivity Analyzers | 391 | ||
| Gas Chromatography | 392 | ||
| Chemoluminescence Analyzers | 393 | ||
| Gas-Conditioning Devices | 394 | ||
| Blood gas analyzers, oximeters, and related devices | 395 | ||
| pH Electrodes | 395 | ||
| Pco2 Electrodes | 396 | ||
| Po2 Electrodes | 398 | ||
| Laboratory Analyzers | 399 | ||
| Point-of-Care Analyzers | 400 | ||
| Transcutaneous Po2 and Pco2 Electrodes | 400 | ||
| Spectrophotometric Oximeters | 401 | ||
| Pulse Oximeter | 402 | ||
| Reflective Spectrophotometers | 405 | ||
| Computers for pulmonary function testing | 406 | ||
| Data Acquisition and Instrument Control | 407 | ||
| Pulmonary Function Data Storage and Programs | 409 | ||
| Temporary Storage or No Data Storage | 409 | ||
| Permanent Individual Patient Data Files | 409 | ||
| Database Storage | 409 | ||
| Summary | 410 | ||
| Self-assessment questions | 411 | ||
| Entry-level | 411 | ||
| Advanced | 411 | ||
| Spirometers | 412 | ||
| Peak Flowmeters | 413 | ||
| Plethysmographs | 413 | ||
| Gas Analyzers | 413 | ||
| Blood Gas Electrodes, Oximeters, and Related Devices | 414 | ||
| Computers | 414 | ||
| Chapter 12: Quality Systems in the Pulmonary Function Laboratory | 415 | ||
| Quality manual | 417 | ||
| Quality system essentials | 418 | ||
| Organization | 418 | ||
| Customer Focus | 418 | ||
| Facilities and Safety | 418 | ||
| Pulmonary Function Tests | 419 | ||
| Blood Gases | 420 | ||
| Personnel | 422 | ||
| Purchasing and Inventory | 424 | ||
| Equipment | 424 | ||
| Installation, Validation, and Verification | 425 | ||
| Equipment Maintenance | 425 | ||
| Process Management | 426 | ||
| Control Methods: Mechanical and Biologic | 426 | ||
| Quality Control Tools and Materials | 426 | ||
| Syringes | 426 | ||
| Sine-Wave Rotary Pumps | 427 | ||
| Computerized Syringes | 428 | ||
| Computer-Driven Syringes | 428 | ||
| Explosive Decompression Devices | 428 | ||
| Dlco Simulator | 428 | ||
| Quality Control Concepts | 429 | ||
| Spirometry Calibration and Mechanical Quality Control | 430 | ||
| Gas Analyzers and Dlco Systems | 434 | ||
| Physiologic Range | 434 | ||
| Sampling Conditions | 434 | ||
| Two-Point Calibration | 435 | ||
| Multiple-Point (Linearity) Calibration | 435 | ||
| Dlco Systems | 436 | ||
| Body Plethysmographs | 438 | ||
| Mouth Pressure Transducer | 438 | ||
| Box Pressure Transducer | 439 | ||
| Flow Transducer | 439 | ||
| Biologic Controls | 440 | ||
| Calibration and Quality Control of Blood Gas Analyzers | 442 | ||
| Tonometry | 445 | ||
| Commercially Prepared Controls | 445 | ||
| Documents and Records | 449 | ||
| Information Management | 449 | ||
| Nonconforming Event Management | 450 | ||
| Assessments | 450 | ||
| Continual Improvement | 451 | ||
| Technologist’s Feedback | 454 | ||
| Path of workflow | 454 | ||
| Pretest Process | 454 | ||
| Testing | 455 | ||
| Test Method Selection | 455 | ||
| Test Performance | 456 | ||
| Using Criteria for Acceptability/Repeatability | 456 | ||
| Examine Printed Tracings or Displayed Graphics Whenever Available | 456 | ||
| Look at Numeric Data | 457 | ||
| Evaluate Key Indicators | 457 | ||
| Posttesting | 459 | ||
| Summary | 459 | ||
| Case studies | 460 | ||
| Entry-level | 463 | ||
| Advanced | 463 | ||
| General References | 464 | ||
| Standards and Guidelines | 464 | ||
| Calibration and Quality Control | 465 | ||
| Chapter 13: Reference Values and Interpretation Strategies | 466 | ||
| Selecting and using reference values | 467 | ||
| Spirometry | 468 | ||
| Lung Volumes | 468 | ||
| Diffusing Capacity | 468 | ||
| Establishing what is abnormal | 469 | ||
| Pulmonary function testing interpretation, “bringing it all together” | 474 | ||
| Interpretation algorithm | 474 | ||
| Quality Review and “The Graph” | 474 | ||
| The Ratio” | 475 | ||
| Gas Exchange | 476 | ||
| Bronchodilator Response | 477 | ||
| Grading Severity and Assessing Change in Lung Function | 477 | ||
| Summary | 478 | ||
| Case studies | 478 | ||
| Entry-level | 485 | ||
| Advanced | 485 | ||
| General | 486 | ||
| Spirometry | 486 | ||
| Lung Volumes | 486 | ||
| Diffusing Capacity | 486 | ||
| Appendix A: Answers to Self-Assessment Questions | 488 | ||
| Chapter 1, Indications for pulmonary function testing | 488 | ||
| Chapter 2, Spirometry | 488 | ||
| Chapter 3, Diffusing capacity tests | 488 | ||
| Chapter 4, Lung volumes, airway resistance, and gas distribution tests | 488 | ||
| Chapter 5, Ventilation and ventilatory control tests | 488 | ||
| Chapter 6, Blood gases and related tests | 488 | ||
| Chapter 7, Cardiopulmonary exercise testing and field tests | 488 | ||
| Chapter 8, Pediatric pulmonary function testing | 489 | ||
| Chapter 9, Bronchoprovocation CHALLENGE testing | 489 | ||
| Chapter 10, Specialized test regimens | 489 | ||
| Chapter 11, Pulmonary function testing equipment | 489 | ||
| Chapter 12, Quality systems in the pulmonary function laboratory | 489 | ||
| Chapter 13, Reference values and interpretation strategies | 489 | ||
| Glossary | 490 | ||
| Index | 508 | ||
| Inside Back Cover | ES3 |