1. Pulmonary Function Tests
Other tests of lung function:1. Lung mechanics -Resistance
-Compliance
2. Distribution of Ventilation
(N2 delta)
3. Maximal Respiratory Pressures
(MIP, MEP)

2. V/Q ratio

3. V/Q mismatch (3-compartment model)

4. Lung volumes and capacities

5. How to measure FRC (RV,TLC) ?
Nitrogen washout method
Inert gas dilution technique
Plethysmography

10. Resistance

11. Volume dependence of airway resistance (Raw)
SRaw (cmH2O/L/sec) 1 2 4 6 8 3
Lung Volume (liters)
TLC RV

12. Compliance

13. Compliance

15. Ventilatory Mechanics: Healthy
100 80 60 40 20
-60
-40
-20
% VC
Pressure (cmH2O)
Pcw
PRS
SRaw  as lung volume  because the airways distend as the lungs inflate, and bigger airways have lower resistance (*Poiseuilles’ Law*). The opposite is also true, of course! PL 15

16. Ventilatory Mechanics: Healthy
100 80 60 40 20
-60
-40
-20
% VC
Pressure (cmH2O)
ΔP ΔV
ΔP ΔV
 elastic WOB
elastic and resistive work of breathing is minimized when tidal breathing occurs within the compliant portion of the respiratory systems P-V curve
SRaw (cmH2O/L/sec) 1 2 4 6 8 3
Lung Volume (liters)
TLC RV
ΔP ΔV
SRaw  as lung volume  because the airways distend as the lungs inflate, and bigger airways have lower resistance (*Poiseuilles’ Law*). The opposite is also true, of course!
 resistive WOB
SRaw  as lung volume  because the airways distend as the lungs inflate, and bigger airways have lower resistance (*Poiseuilles’ Law*). The opposite is also true, of course! 16

17. Ventilatory Mechanics: HealthyVT IC
Begin Exercise IC 17

18. Ventilatory Mechanics: Healthy
Volume (liters) 2 4 6 8
-20 10 20
Pressure (cmH20)
-30
-40
-10 30 40 50
TLC
 EILV
 IRV
 IC
 VT
EELV
 EELV RV 18

19. Dynamic hyperinflation during exercise
IRV
IRV

22. Diffusion capacity (DLCO, DLCO/VA, Tco, Kco)

30. Mechanism of hypoxaemia

31. Hypoxaemia, hypercapnia in clinical cases

32. Respiratory and metabolic shifts
chronic
acute
acute
chronic

33. Exercise tests in lung diseases
Exercise-induced asthma (EIA) - FEV1
Interstitial lung disease (ILD) - SAT
Exercise tolerance in rehabilitation (COPD) -
cardiopulmonary exercise (CPX). Important
variables: - work rate (watts), SpO2, ABG
- VO2, VCO2, RQ, VE
- lactate threshold (LT)
- breathing reserve (1-VEmax/MVV)
- heart rate reserve (1-HRmax/220-age)

34. Mechanism of
exercise-induced
hypoxaemia

37. Noninvasive determination of lactate threshold by the
V-slope method

38. Exercise training 1. Endurance –leg, arm -Wmax. 60-90%
min, 3x/weeek
2. Strength -max. weight 80%
- 8 repetitions, 3 series
- 3x/week
3. Respiratory muscle - selected cases (reduced breathing reserve)
- Müller manouver, >PImax 30%

39. Respiration during exercise
( Wasserman K, 1999 )