All existing external respiration function tests in the world can be done here at IntegraMedservice quickly and professionally.

• If you need an assessment or examination of respiratory function - spirography, body plethysmography, assessment of the diffusion capacity of the lungs, feel free to contact us
• If you need spirography for a planned operation, we will quickly do it and give a detailed conclusion.
• Need spirometry at home? Nothing could be easier! We conduct spirometry at home, both as a separate study and as part of a consultation with a pulmonologist at home
• We perform spirography for children
• if necessary, we can immediately give .

Spirometric study

Spirography is an informative, non-invasive, painless study of pulmonary function. Using this method, it is possible to determine whether there are changes in the speed of air passage through the bronchi, the nature of this disorder, how the air passes through the bronchi and the forced vital capacity of the lungs.

Why is Spirometry and spirography needed?

1. allows you to accurately diagnose broncho-obstructive lung diseases: with bronchial obstruction, bronchiolitis.
2. suspect restrictive lung diseases.
3. Spirometry is often necessary for anesthesiologists before elective surgery under general anesthesia.
4. Spirometry is performed for both children and adult patients. For children, it is carried out provided that the child complies with the commands of the doctor conducting the study.

How is spirometry performed?

When performing spirometry in our medical center

• The pulmonologist will ask you to make three attempts to maximally inhale and exhale into a special device (spirograph) through a disposable mouthpiece-tube.
• all obtained results are stored and processed by the device.
• Having received the result, the doctor immediately gives a written conclusion.
• Especially for children, when conducting physical exercise, we use an animation program built into the computer. It’s easier and more fun for a child to go through a boring, but necessary, doctor’s visit.

Spirometry with a bronchodilator (bronchodilator)

This is carrying out the above-described spirometry after inhaling, using a certain maneuver, a bronchodilator drug (ventolin, salbutamol, berodual). According to all the rules, it must be carried out without fail, since hidden bronchospasm can be missed. In addition, the test allows you to determine whether bronchodilators can help you, and which ones.

The total duration of full spirometry with a bronchodilator takes 20 minutes.

Bronchoprovocation test with methacholine

This is a study of physical activity with inhalation of the drug methacholine. This type of spirometry allows us to identify hyperreactivity and readiness for bronchospasm in patients with a controversial diagnosis of bronchial asthma, the “cough” version of bronchial asthma and physical exertion asthma. In other words, it allows you to detect any bronchial asthma. In these conditions, routine spirometry is normal, but the bronchodilator test is negative. And only an expert test with methacholine can correctly diagnose whether you have asthma or not.

Rules for preparing for the study of respiratory function: spirometry, body plethysmography

Breath tests are not recommended if:
pain in the heart, angina pectoris
after eye, chest or abdominal surgery
recent pneumothorax
with individual sensitivity to drugs

Some tips:

• do not take bronchodilators (discuss the period of non-use with your pulmonologist)
• do not overeat - a full stomach will interfere with the correct maneuvers
• do not smoke or exercise at least 6-8 hours before the test

Do you want to do spirography of external respiration function?
Why do we make FVD better?
Where should you do: spirometry, body plethysmography, methacholine test?

• IntegraMedservice medical center has a license for functional diagnostics and pulmonology
• in the pulmonology department of our medical center we will carry out all the necessary breathing tests at the highest professional level
• We employ pulmonologists and specialists in the study of external respiration function only from the Research Institute of Pulmonology
• we know how to work with children
• we can perform spirometry at home
• you immediately get the result and, if you want, a consultation with a pulmonologist
• the opinions of our specialists are authoritative in medical circles

One of the most important diagnostic methods in pulmonology is the study of external respiratory function (RPF), which is used as part of the diagnosis of diseases of the bronchopulmonary system. Other names for this method are spirography or spirometry. Diagnosis is based on determining the functional state of the respiratory tract. The procedure is completely painless and takes little time, so it is used everywhere. FVD can be performed on both adults and children. Based on the results of the examination, we can draw a conclusion about which part of the respiratory system is affected, how much functional indicators are reduced, and how dangerous the pathology is.

Examination of external respiration function - RUB 2,200.

Pulmonary function testing with inhalation test
- 2,600 rub.

10 - 20 minutes

(duration of procedure)

Outpatient

Indications

• The patient has typical complaints of respiratory distress, shortness of breath and cough.
• Diagnosis and control of treatment of COPD, asthma.
• Suspicions of lung diseases discovered during other diagnostic procedures.
• Changes in laboratory parameters of gas exchange in the blood (increased carbon dioxide content in the blood, decreased oxygen content).
• Examination of the respiratory system in preparation for operations or invasive examinations of the lungs.
• Screening examination of smokers, workers in hazardous industries, people suffering from respiratory allergies.

Contraindications

• Bronchopulmonary hemorrhage.
• Aortic aneurysm.
• Any form of tuberculosis.
• Stroke, heart attack.
• Pneumothorax.
• The presence of mental or intellectual disorders (may interfere with following the doctor’s instructions, the study will be uninformative).

What is the purpose of the study?

Any pathology in the tissues and organs of the respiratory system leads to breathing problems. Changes in the functional state of the bronchi and lungs are reflected in the spirogram. The disease can affect the chest, which acts as a kind of pump, the lung tissue, which is responsible for gas exchange and oxygenation of the blood, or the respiratory tract, through which air must pass freely.

In case of pathology, spirometry will show not only the fact of respiratory dysfunction, but will also help the doctor understand which part of the lungs is affected, how quickly the disease progresses, and what therapeutic measures will help best.

During the examination, several indicators are measured at once. Each of them depends on gender, age, height, body weight, heredity, physical activity and chronic diseases. Therefore, interpretation of the results should be made by a physician familiar with the patient's medical history. Typically, the patient is referred for this test by a pulmonologist, allergist or general practitioner.

Spirometry with bronchodilator

One of the options for conducting FVD is a study with an inhalation test. This study is similar to regular spirometry, but the values ​​are measured after inhalation of a special aerosol drug containing a bronchodilator. A bronchodilator is a drug that dilates the bronchi. The study will show whether there is hidden bronchospasm, and will also help you choose the appropriate bronchodilators for treatment.

As a rule, the study takes no more than 20 minutes. The doctor will tell you what and how to do during the procedure. Spirometry with a bronchodilator is also completely harmless and does not cause any discomfort.

Methodology

External respiration function is a study that is carried out using a special device - a spirometer. It allows you to record the speed, as well as the volume of air that enters and exits the lungs. The device has a built-in special sensor that allows you to convert the received information into digital data format. These calculated indicators are processed by the doctor conducting the study.

The examination is carried out in a sitting position. The patient puts a disposable mouthpiece connected to the spirometer tube into his mouth and closes his nose with a clip (this is necessary so that all breathing occurs through the mouth and the spirometer takes into account all the air). If necessary, the doctor will tell you the procedure algorithm in detail to make sure that the patient understands everything correctly.

Then the research itself begins. You need to follow all the doctor’s instructions and breathe in a certain way. Typically, tests are carried out several times and the average value is calculated to minimize error.

A bronchodilator test is performed to assess the degree of bronchial obstruction. Thus, the test helps to distinguish COPD from asthma, as well as clarify the stage of development of the pathology. As a rule, spirometry is first performed in the classical version, then with an inhalation test. Therefore, the study takes approximately twice as long.

Preliminary (not interpreted by a doctor) results are ready almost immediately.

Frequently Asked Questions

How to prepare for research?

Smokers will have to give up their bad habit for at least 4 hours before the study.

General preparation rules:

• Avoid physical activity.
• Avoid any inhalations (except for inhalations for asthmatics and other cases of mandatory medication use).
• The last meal should be 2 hours before the examination.
• Refrain from taking bronchodilators (if therapy cannot be canceled, then the decision on the need and method of examination is made by the attending physician).
• Avoid foods, drinks and medications with caffeine.
• You need to remove lipstick from your lips.
• Before the procedure, you need to loosen your tie and unbutton your collar so that nothing interferes with free breathing.

Various methods are used to diagnose the bronchopulmonary system. One of the most informative tests is the assessment of external respiratory function (RPF). FVD includes: spirometry, body plethysmography, diffusion test, stress tests, bronchodilator test. Sounds a little scary, right? But in fact, all these tests are completely painless and safe. Lung disease can make some lung tests a little tedious or cause slight dizziness, coughing, or rapid heartbeat. These symptoms pass quickly, and a pulmonologist is constantly nearby and monitors the patient’s condition.

Let's take a closer look at the function of external respiration. Why is each test needed? How is a lung examination performed, how to prepare for it and where to get a lung examination?

2. Types of pulmonary tests

Spirometry

Spirometry is the most common lung examination. Spirometry shows whether the patient has bronchial obstruction (bronchospasm) and evaluates how air circulates in the lungs.

During spirometry, your doctor may check, for example:

What is the maximum amount of air you can exhale after a deep breath; how quickly you can exhale; what is the maximum amount of air you can inhale and exhale within a minute; how much air remains in the lungs at the end of a normal exhalation.

How is spirometry performed? You will have to breathe through a special mouthpiece and follow the instructions of your pulmonologist. The doctor may ask you to inhale as deeply as possible and then exhale as completely as possible. Or you will have to inhale and exhale as often and deeply as possible for a certain time. All results are recorded by the device, and then they can be printed in the form of a spirogram.

Diffusion test

A diffusion test is performed to evaluate how well oxygen from the inhaled air penetrates into the blood. A decrease in this indicator may be a sign of lung disease (and in a rather advanced form) or other problems, for example, pulmonary embolism.

Bodyplethysmography

Body plethysmography is a functional test that is somewhat similar to spirometry, but body plethysmography is more informative. Body plethysmography makes it possible to determine not only bronchial patency (bronchospasm) as with spirometry, but also to evaluate lung volumes and air traps (due to increased residual volume), which may indicate the presence of pulmonary emphysema.

How is body plethysmography performed? During body plethysmography, you will be inside a sealed plethysmograph cabin, somewhat reminiscent of a telephone booth. And just like with spirometry, you will have to breathe into a mouthpiece tube. In addition to measuring respiratory functions, the device monitors and records the pressure and volume of air in the cabin.

Lung test with bronchodilator

A bronchodilator test is done to find out whether the bronchospasm is reversible, i.e. Is it possible to relieve the spasm and help in case of an attack with the help of medications that affect the smooth muscles of the bronchi.

Lung stress tests

A lung stress test means your doctor will check how well your lungs function after exercise. For example, spirometry at rest and then spirometry after performing several physical exercises would be indicative. Among other things, stress tests help diagnose exercise asthma, which often manifests itself in the form of a cough after exercise. Exercise asthma is an occupational disease of many athletes.

Lung provocative test

A lung provocative test with methacholine is a way to accurately diagnose bronchial asthma in the case when all the signs of asthma are present (history of asthma attacks, allergies, wheezing), and the test with a bronchodilator is negative. For a provocative test of the lungs, inhalation is performed with a gradually increasing concentration of a methacholine solution, which artificially causes the manifestation of clinical symptoms of bronchial asthma - difficulty breathing, wheezing, or affects lung function (decrease in forced expiratory volume).

3. Preparation for examination of pulmonary function (PRF)

There is no need to prepare specially for a pulmonary examination (PPE). But in order not to harm your own health, you must tell your doctor if you have recently had chest pain or a heart attack, if you have had surgery on your eyes, chest or abdominal area, or if you have had a pneumothorax. You should also tell your doctor about drug allergies and bronchial asthma.

Before examining the lungs and bronchi, you should avoid eating heavy foods, since a full stomach can make it difficult for the lungs to fully expand. 6 hours before the examination of the lungs and bronchi, you should not smoke or exercise. Also, avoid drinking coffee or other caffeinated drinks as they can cause the airways to relax, allowing more air to pass through the lungs than in their normal physiological state. Also, on the eve of the examination, you should not take bronchodilator medications.

Depending on the program, examination of the lungs and bronchi can take from 5 to 30 minutes. The accuracy and effectiveness of the external respiration function largely depends on how correctly you follow the instructions of the pulmonologist.

Normal gas exchange in the lungs is ensured by adequate perfusion

ventilation ratio. In turn, pulmonary ventilation depends on the condition of the lung tissue, chest and pleura (static characteristics), as well as on the patency of the airways (dynamic characteristics).

Static parameters of pulmonary ventilation include

the following indicators:

1. Tidal volume (TV) - the amount of air inhaled and exhaled during quiet breathing. Normally it is 500-800 ml.

2. Inspiratory reserve volume (IRV) is the volume of air that a person can inhale after a normal inhalation. Normally it corresponds to 1500-2000 ml.

3. Expiratory reserve volume (ERV) is the volume of air that a person can exhale after normal exhalation. Normally, it usually corresponds to 1500-2000 ml.

4. Vital capacity (VC) is the volume of air that a person can exhale after a maximum inhalation. Usually it is 300-5000 ml.

5. Residual lung volume (RLV) - the volume of air remaining in the lungs after maximum exhalation. Usually it corresponds to 1500 ml.

6. Inspiratory capacity (EIC) is the maximum volume of air that a person can inhale after a quiet exhalation. It includes the DO and ROVD.

7. Functional residual capacity (FRC) - the volume of air contained in the lungs at the height of maximum inspiration. It includes the amount of OOL and ROvyd.

8. Total lung capacity (TLC) - the volume of air contained in the lungs at the height of maximum inspiration. It includes the sum of the total and vital capacity.

Dynamic parameters include the following speed indicators:

1. Forced vital capacity (FVC) - the amount of air that a person can exhale at maximum speed after a maximum deep breath.

2. Forced expiratory volume in 1 second (FEV1) - the amount of air that a person can exhale in 1 second after taking a deep breath. Usually this indicator is expressed in % and it averages 75% of vital capacity.

3. Tiffno index (FEV1/FVC) is indicated in % and reflects both the degree of obstructive impairment of pulmonary ventilation (if less than 70%) and restrictive (if more than 70%).

4. Maximum volumetric flow rate (MVF) reflects the maximum volumetric flow rate of forced expiration averaged over the period of 25-75%.

5. Peak expiratory flow (PEF) is the maximum volumetric flow rate of forced expiration, usually determined on a peak flow meter.

6. Maximum pulmonary ventilation (MVV) - the amount of air that a person can inhale and exhale with maximum depth in 12 seconds. Expressed in l/min. Typically, the MVL averages 150 l/min.

The study of static and dynamic indicators is usually carried out using the following methods: spirography, spirometry, pneumotachometry, peak flowmetry.

In pathology, there are two main types of pulmonary ventilation disorders: restrictive and obstructive.

The restrictive type is associated with disturbances in the respiratory excursion of the lungs, which is observed in diseases of the lungs, pleura, chest and respiratory muscles. The main indicators for the restrictive type of ventilation impairment include vital capacity, which also allows you to monitor the dynamics of restrictive pulmonary disease and the effectiveness of treatment; OEL, FOE, DO, ROVD. In pathology, these indicators decrease.

The obstructive type of pulmonary ventilation disorder is associated with a violation of the passage of air flow through the respiratory tract. This may be due to a narrowing of the airways and an increase in aerodynamic resistance, due to the accumulation of secretions during bronchitis and bronchiolitis, swelling of the bronchial mucosa, spasm of the smooth muscles of the small bronchi (bronchial asthma), early expiratory collapse of the small bronchi with emphysema, laryngeal stenosis.

Main indicators reflecting the obstructive type of ventilation impairment: FEV1; Tiffno index, maximum expiratory volumetric flow rate at 25%, 50% and 75%; FVC and peak expiratory flow rate decrease in pathology.

Spirometry is the most important way to assess pulmonary function.

Spirography– a method of graphically recording lung volume during breathing, one of the main methods for diagnosing respiratory diseases.

Allows you to evaluate:

functional state of the lungs and bronchi (in particular the vital capacity of the lungs) –

airway patency

detect obstruction (bronchial spasm)

degree of severity of pathological changes.

Indications for spirometry:

Symptoms: shortness of breath, stridor, orthopnea, cough, sputum production, chest pain;

Objective examination data: weakened breathing, difficulty exhaling, cyanosis, chest deformation;

Abnormalities in laboratory tests: hypoxemia, hypercapnia, polycythemia, changes in chest x-rays.

2. Identifying people at risk of pulmonary diseases:

Smokers;

Persons whose work or service involves exposure to harmful substances.

3. Preoperative risk assessment.

4. Assessing the prognosis of the disease.

5. Assess your health status before participating in programs that require excessive physical effort.

6. Evaluation of therapeutic interventions and monitoring the effectiveness of treatment of acute and chronic lung diseases.

7. Supervision of persons working with harmful agents.

8. Military medical and medical labor examination.

Contraindications for spirometry:

1. Conditions requiring emergency care.

2. The presence of an acute (contagious) period of infectious diseases.

3. Conditions accompanied by disorientation and inappropriate behavior of the patient.

4. Changes in the area of ​​the ENT organs, maxillofacial area, chest, preventing the test or its adequate assessment.

6. Young children.

TOabsolute contraindications Spirometric studies include:

Moderate or severe hemoptysis of unknown etiology;

Established or suspected pneumonia and tuberculosis;

Recent or existing pneumothorax on the day of examination;

Recent surgical intervention.

Fresh acute myocardial infarction, hypertensive crisis or stroke;

Methodology for studying the function of external respiration.

The study should be carried out after half an hour's rest lying in bed or sitting in a chair with armrests in a well-ventilated room at a temperature of 18-20C.

Before the study begins, the patient must sit for 5-10 minutes.

Age, height and gender must be recorded. Take into account the race of the person being studied and make appropriate adjustments if necessary.

The patient should avoid smoking for 24 hours before the test, drinking alcohol, wearing clothing that compresses the chest, eating large meals 2-3 hours before the test, and using short-acting bronchodilators at least 4 hours before the test. If the patient cannot be without a bronchodilator for health reasons, the dose and time of taking the latter should be reflected in the study protocol.

Although the most informative part of the spirographic study is the dynamic (speed) characteristics of the respiratory act, this method is also used to study the static characteristics of breathing (total lung capacity and its structure).

Total lung capacity (TLC) corresponds to the volume of air that the lungs can hold when expanding from full collapse to the position of maximum inspiration. There are four volumes and four containers that make up the structure of the OEL.

Lung volumes:

- inspiratory reserve volume (IRV)- The maximum volume of air that can be inhaled after a quiet breath. The norm is 1500-2000ml.

- tidal volume (TO)– the volume of air inhaled and exhaled during each respiratory cycle. On the graph it is represented by a curve between the levels of quiet exhalation and quiet inhalation; norm is from 300 to 900 ml.

- expiratory reserve volume (ERV)- This is the maximum volume of air that can be exhaled after a quiet exhalation. The norm is 1500-2000ml.

- residual lung volume (RLV,RV) is the volume of gas remaining in the lungs after maximum exhalation. OOL=FOE-ROvyd. The residual volume is 1000-1500 ml.

Pulmonary capacities:

- inspiratory capacity (Evd)=DO+ROvd;

- vital capacity of the lungs (VC,V.C.) - this is the maximum amount of air that can be exhaled after taking the deepest breath possible. VIT=ROVD+DO+ROVD;

- total lung capacity (TLC,TLC) =VEL+OOL. TEL is the amount of air in the lungs after maximum inspiration. The norm is 5000-6000ml. (Residual volume cannot be determined using spirometry alone; it requires additional lung volume measurements.)

- functional residual capacity (FRC) is the amount of gas in the lungs after a quiet exhalation.

In addition to the listed characteristics, the following indicators are also used to evaluate spirometry:

- minute volume of respiration (MOV)- this is the amount of air ventilated by the lungs in 1 minute. It is calculated as the product of DO and RR (breathing frequency). The average is 5000ml.

- forced vital capacity (FVC, FVC)- the amount of air that can be exhaled during a forced exhalation after a deep maximum inspiration.

- forced expiratory volume in 1 second of the FVC maneuver (FEV1, FEV1). This is one of the main indicators characterizing lung ventilation. FEV1 reflects mainly the speed of expiration in the initial and middle parts and does not depend on the speed at the end of forced expiration.

- maximum ventilation (MVV)- this is the maximum amount of air that can be ventilated by the lungs within 1 minute. Normally it is 80-200 l/min.

- respiratory reserve (RR)– an indicator characterizing the patient’s ability to increase pulmonary ventilation. RD=MVL-MOD. Normally, RD=85-90%MVL.

- index (test) Tiffno (TT)– the ratio FEV1/VC or FEV1/FVC, expressed as a percentage, is usually calculated. Normal is 70-89%.

- MOS 25 (FEF25%)– instantaneous volumetric air velocity at the expiratory level is 25% of FVC.

- MOS 50 (FEF50%)– instantaneous volumetric air velocity at the expiratory level of 50% of FVC.

- MOS 75 (FEF75%)– instantaneous volumetric air velocity at the expiratory level is 75% of FVC.

- SOS 25-75– forced expiratory volumetric rate, averaged over a certain measurement period – from 25% to 75% FVC. The indicator primarily reflects the condition of the small airways, is more informative than FEV1 in identifying early obstructive disorders, and does not depend on effort.

- POS (PEF)– peak (maximum) volumetric expiratory flow rate when performing the FVC test.

- MOS50%vd (MIF50%)– maximum volumetric inspiratory flow rate at 50% of the vital capacity of the lungs.

- MIP (mm.in.st.)– Maximum inspiratory pressure (achieved at the lowest pulmonary volume (RV) when the length-tension relationship in the diaphragm is optimized).

- MEP (mm.in.st.)– maximum expiratory pressure (Patients with neuromuscular diseases are often unable to achieve maximum pressure values, which suggests restrictive pulmonary pathology).

Analysis and evaluation of spirometric study results

Interpretation or interpretation of spirometric test data comes down to analyzing the absolute values ​​of FEV1, FVC and their ratio (FEV1/FVC), comparing these data with expected (normal) values ​​and studying the shape of the graphs. Data obtained after three attempts can be considered reliable if they do not differ from each other by more than 5% (this corresponds to approximately 100 ml).

Based on the spirogram, we can conclude that the patient has one of two variants of pulmonary ventilation dysfunction: obstructive, the pathogenesis of which is associated with airway obstructions, or restrictive (restrictive), which occurs when there are obstacles to the normal expansion of the lungs during inspiration.

In the obstructive variant, bronchial obstruction may be caused by a combination of spasm of the smooth muscles of the bronchi (bronchospasm), edematous-inflammatory changes in the bronchial tree (swelling and hypertrophy of the mucous membrane, hyper- and discrinia, accumulation of pathological contents in the lumen of the bronchi, inflammatory infiltration of the bronchial wall), expiratory collapse of small bronchi, pulmonary emphysema, tracheobronchial dyskinesia. Since nonspecific lung diseases (COPD, bronchial asthma, bronchiectasis) are characterized by bronchial genesis, the obstructive variant of ventilation disorders is most common in them.

As a result of processes that limit the maximum excursions of the lungs and reduce the level of maximum inspiration, a restrictive variant of ventilation disorders develops. These are diffuse pneumosclerosis, atelectasis, cysts and tumors, the presence of gas or liquid in the pleural cavity, massive pleural adhesions, deformation or stiffness of the chest (kyphoscoliosis, ankylosing spondylitis), morbid obesity, absence of a lung (due to surgical removal).

A mixed type of impairment of the ventilation capacity of the lungs is relatively common.