Muutke küpsiste eelistusi

Making Sense of Lung Function Tests: A hands-on guide 2nd edition [Kõva köide]

(Havant, UK), , (Portsmouth Hospitals NHS Trust, UK)
  • Formaat: Hardback, 204 pages, kõrgus x laius: 198x129 mm, kaal: 570 g, 34 Tables, black and white; 48 Line drawings, black and white; 4 Halftones, black and white; 52 Illustrations, black and white
  • Sari: Making Sense of
  • Ilmumisaeg: 21-Jul-2017
  • Kirjastus: CRC Press
  • ISBN-10: 1138091472
  • ISBN-13: 9781138091474
Teised raamatud teemal:
  • Formaat: Hardback, 204 pages, kõrgus x laius: 198x129 mm, kaal: 570 g, 34 Tables, black and white; 48 Line drawings, black and white; 4 Halftones, black and white; 52 Illustrations, black and white
  • Sari: Making Sense of
  • Ilmumisaeg: 21-Jul-2017
  • Kirjastus: CRC Press
  • ISBN-10: 1138091472
  • ISBN-13: 9781138091474
Teised raamatud teemal:
Respiratory problems are the most common cause of acute admission to hospital. A variety of diagnostic investigations are required, both for acute and clinic assessment. Making Sense of Lung Function Tests, Second Edition familiarises both trainees and more experienced clinicians with the interpretation of a range of respiratory parameters. It places lung function in a clinical context using real-life examples and provides invaluable hands-on guidance.

For this second edition Consultant Respiratory Physician Jonathan Dakin and Consultant Anaesthetist Elena Kourteli are joined by Mark Mottershaw, Chief Respiratory Physiologist from Queen Alexandra Hospital, Portsmouth, all contributing a broad range of expertise and perspectives. Together they have updated the book throughout and added new chapters including an algorithm for interpretation of pulmonary function tests, exhaled nitric oxide (FENO) and cardiopulmonary exercise testing.

The text offers a clear explanation of the concepts which students find difficult, including:











The basis of obstructive and restrictive defects





Pattern recognition of the flow volume loop





Differences between TLCO and KCO





Assessment of oxygenation using PO2 and SO2





The basis of Type 1 and type 2 respiratory failure





Distinguishing respiratory and metabolic acidosis





The relationship between sleep and respiratory failure

The information is presented in an accessible way, suitable for those seeking a basic grounding in spirometry or blood gases, but also sufficiently comprehensive for readers completing specialist training in general or respiratory medicine.
Preface xv
Acknowledgement xv
Abbreviations xvii
1 Expressions of normality
1(4)
Part 1 Tests Of Airway Function And Mechanical Properties 5(98)
2 Peak expiratory flow
7(6)
Introduction
7(1)
Test description and technique
7(1)
Pitfalls
7(1)
Physiology of test
8(1)
Normal values
8(1)
Peak flow variability in the diagnosis of asthma
8(3)
Assessment and management of asthma
11(1)
Pitfall
12(1)
3 Spirometry and the flow-volume loop
13(22)
Introduction
13(1)
Measured indices and key definitions
13(1)
Test description and technique
13(3)
Physiology of tests
16(2)
Restrictive and obstructive defects
16(7)
Restrictive defects
16(2)
Obstructive defects
18(1)
Maximum expiratory flows
18(2)
Normal values
20(1)
Assessment of severity of obstruction
21(1)
Mid-expiratory flows
22(1)
FVC versus VC
23(1)
Patterns of abnormality
23(4)
Obstructive spirometry
23(2)
Restrictive spirometry
25(2)
Reduction of FEVi and FVC
27(1)
Mixed obstructive/restrictive defect
27(1)
Non-specific ventilatory defect
28(1)
Large airways obstruction
29(1)
Fixed upper airway obstruction
29(1)
Variable extrathoracic obstruction
29(2)
Variable intrathoracic obstruction
31(1)
Clinical pearls
31(4)
4 Airway responsiveness
35(6)
Introduction
35(1)
Test physiology
35(1)
Test descriptions
36(1)
Reversibility
36(1)
Challenge testing
37(1)
Interpretation of results
37(4)
Reversibility
37(1)
Challenge testing
38(3)
5 Fractional concentration of expired nitric oxide
41(4)
Introduction
41(1)
Test description/technique
41(1)
Physiology of test
42(1)
Normal values and interpretation
43(1)
Specific considerations
44(1)
6 Gas transfer
45(12)
Introduction
45(1)
Measured indices/key definitions
45(2)
Alveolar volume
46(1)
KCo
46(1)
Test description
47(1)
Physiology of gas exchange
48(1)
Normal values
48(1)
Patterns of abnormality
49(5)
Incomplete lung expansion
49(2)
Discrete loss of lung units
51(1)
Diffuse loss of lung units
52(1)
Pulmonary emphysema
52(1)
Pulmonary vascular disease
53(1)
Causes of increased gas transfer
54(1)
Clinical pearls
54(3)
Interstitial lung disease
54(1)
Obstructive disease
55(1)
Acute disease
56(1)
7 Static lung volumes and lung volume subdivisions
57(16)
Introduction
57(1)
Measured indices/key definitions
57(2)
Test descriptions/techniques
59(5)
Helium dilution
59(2)
Nitrogen washout
61(1)
Whole-body plethysmography
61(2)
Comparison of methods
63(1)
Physiology of lung volumes
64(1)
Total lung capacity
64(1)
Residual volume
64(1)
Functional residual capacity
64(1)
Closing capacity
65(1)
Normal values
65(1)
Patterns of abnormality
66(2)
Relationship between VC and TLC
67(1)
Obstructive lung disease
67(1)
Interstitial lung disease
67(1)
Miscellaneous
68(1)
Specific considerations
68(2)
Anaesthesia
68(1)
FRC in patients receiving ventilatory support: PEEP and CPAP
68(2)
Clinical pearls
70(3)
8 Airway resistance
73(14)
Introduction
73(1)
Physiology of airway resistance tests
74(1)
Plethysmography technique
75(1)
Test description/technique
75(1)
Measured indices/key definitions
76(1)
Normal values
76(1)
Patterns of abnormality
76(3)
Oscillometry techniques
79(5)
Test description/technique
79(1)
Measured indices/key definitions
79(3)
Normal values
82(1)
Patterns of abnormality
82(2)
Assessment of severity
84(1)
Specific and clinical considerations
84(3)
9 Respiratory muscle strength
87(16)
Introduction
87(1)
Test descriptions/techniques
87(6)
Upright and supine vital capacity
87(3)
Static lung volumes
90(1)
Maximal expiratory pressure
90(1)
Maximal inspiratory pressure
90(1)
Sniff nasal inspiratory pressure
90(1)
Sniff trans-diaphragmatic pressure
91(1)
Direct electromagnetic phrenic nerve stimulation
91(1)
Cough peak flow
91(1)
Arterial blood gases
92(1)
Radiological assessment of muscle strength
92(1)
Clinical interpretation of tests of muscle strength
93(2)
Forced vital capacity
93(1)
Sniff nasal inspiratory pressure
94(1)
MIP and MEP
94(1)
The twitch PDI
95(1)
Sleep, ventilatory failure, and VC
95(4)
Clinical pearls
99(4)
Part 2 Blood Gas Interpretation 103(42)
10 Assessment of ventilation
105(10)
Introduction
105(1)
Measured indices/key definitions
105(1)
Physiology of ventilation in relation to CO2
105(3)
Normal values
108(1)
Measurement of venous blood gases
109(1)
Causes of hypercapnia
109(3)
Chronic obstructive pulmonary disease
110(1)
Obesity hypoventilation syndrome
111(1)
Exhaustion
111(1)
Increased CO2 production
112(1)
Causes of low PCo2
112(1)
Hypoxaemia
112(1)
Metabolic acidosis
112(1)
Central nervous system disorders
112(1)
Drugs
112(1)
Anxiety
113(1)
Clinical pearls
113(2)
11 Assessment of haemoglobin saturation
115(10)
Introduction
115(1)
Measured indices
115(1)
Measurement of oxygen saturation
116(4)
Pulse oximetry
117(3)
Waveform
117(1)
Accuracy
118(1)
Specific sources of error
119(1)
Pros and cons of pulse oximetry
120(1)
Physiology - oxygen dissociation curve
120(2)
What determines the amount of oxygen carried in blood?
121(1)
Normal values
122(1)
Carbon monoxide poisoning
122(1)
Clinical pearls
123(2)
12 Assessment of oxygenation
125(12)
Introduction
125(1)
Normal values
125(1)
Measurement of PaO2
125(1)
Measurement of arterialised capillary PO2
126(6)
The oxygen cascade
127(1)
Humidification of dry air
128(1)
Alveolar gas
128(1)
Arterial blood
129(3)
A-a partial pressure PO2 difference
129(3)
Tissue
132(1)
Relationship between alveolar PO2 and arterial PCO2
132(1)
Clinical pearls
133(1)
Specific clinical considerations
133(4)
Hypoxaemia
133(1)
Apnoeic respiration
134(1)
Chronic respiratory failure
135(2)
13 Assessment of acid-base balance
137(8)
Introduction
137(1)
Measured indices/key definitions
137(1)
Physiology of acid-base balance
138(2)
Compensation
139(1)
Classification of acid-base disorders
140(1)
Respiratory disorder
140(1)
Metabolic disorder
140(1)
Evaluating compensation of acid-base disturbance
141(2)
Respiratory compensation for metabolic disorder
142(1)
Metabolic compensation for respiratory disorder
142(1)
Time course of compensation
143(1)
Summary: Evaluation of acid-base disorders
143(2)
Part 3 Exercise Testing 145(28)
14 Field exercise tests
147(8)
Introduction
147(1)
Measurement indices
147(1)
Description of tests
148(1)
Six-minute walk test
148(1)
Incremental shuttle walk test
149(1)
Endurance shuttle walk test
149(1)
Choice of field-walking test
149(1)
Physiology of field exercise tests
150(1)
Normal values
151(1)
Six-minute walk test
151(1)
Incremental shuttle walk test
151(1)
Endurance shuttle walk test
151(1)
Clinical pearls
152(3)
15 Cardiopulmonary exercise testing
155(18)
Introduction
155(1)
Measured indices/key definitions
155(1)
Test description/technique
155(4)
Physiology of exercise testing
159(6)
Normal physiological responses
159(5)
Normal values
164(1)
Patterns of abnormality
165(4)
Exercise tolerance
165(1)
Lung disease
165(1)
Heart disease - ischaemic heart disease
166(2)
Heart disease - cardiomyopathy
168(1)
Pulmonary vascular disease
168(1)
Summary
169(1)
Assessment of severity
169(2)
Specific considerations
171(2)
Part 4 Interpretation 173(16)
16 A strategy for interpretation of pulmonary function tests
175(8)
Introduction
175(8)
17 Characteristic pulmonary function abnormalities
183(6)
Airway diseases
183(2)
Asthma
183(1)
Chronic obstructive pulmonary disease
183(1)
Bronchiolitis
184(1)
Bronchiectasis
184(1)
Large airway obstruction - variable extrathoracic
184(1)
Large airway obstruction - variable intrathoracic
184(1)
Fixed upper airway obstruction
185(1)
Restrictive diseases interstitial lung disease
185(2)
Pleural disease
185(1)
Chest wall deformity
186(1)
Muscle weakness
186(1)
Post-pulmonary resection surgery
186(1)
Pulmonary vascular disease
187(2)
Pulmonary arterial hypertension
187(1)
Recurrent pulmonary emboli
187(1)
Chronic pulmonary venous congestion
187(1)
Carbon monoxide poisoning
187(2)
References 189(8)
Index 197
Jonathan Dakin MD FRCP BSc Hons, is Consultant Respiratory Physician at Royal Surrey County Hospital NHS Foundation Trust, Surrey. He is also Honorary Consultant Respiratory Physician at Portsmouth Hospitals NHS Trust, Hampshire.

Mark Mottershaw is Chief Respiratory Physiologist at Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Hampshire.

Elena Kourteli is Consultant Anaesthetist at St Georges University Hospitals Foundation NHS Trust, London.