1. SPIROMETRY Blow to know Dr.Johan Buffels Belgian Primary Care Respiratory Group

2. BPCRG Belgian Primary Care Respiratory Group Domus Medica (wetenschappelijke vereniging van vlaamse huisartsen) Société Scientifique de Médecine Générale University Departments of General Practice

3. What is Spirometry? a simple and safe test that measures lung volumes with a graphical display gives an estimation of lung function Allows for diagnosis of airflow obstruction Permits good follow-up for asthma and COPD

4. Hand-held spirometer

5. Spirometer in the fifties..

6. In the lung function lab

7. Spirobank Simplicity SpiroPro SpiroStar Datospir 70 Many types are available.. MicroLoop

8. What do we measure with a spirometer?

10. 51015 2 4 6 8 Time (s) Volume (L) Normal spirogram: Volume / time Man 176 cm 76 kg FVC FEV 1

11. Two important parameters FVC - Forced Vital Capacity. This is the total amount of air that you blow out in one breath. FEV1 - Forced Expiratory Volume in one Second. This is the amount of air you can blow out within one second. With normal lungs and airways you can normally blow out most of the air from your lungs within one second.

12. Spirometry: Normal and COPD

13. 0 -4 -8 4 8 12 Flow (L/s) PEF Normal spirogram: Flow/Volume Man 176 cm 76 kg Volume (L)

15. Spirometry and ageing 25 yrs 175 cm male 75 yrs 171 cm male

16. Spirometry allows for Early detection of airflow obstruction (often late signs and symptoms) Better diagnosis (helps to distinguish between asthma and COPD) Correct follow-up (compare with blood pressure meter in hypertension patients)

17. Reversibility Testing If airflow obstruction is present, the test person is given a bronchodilator (inhalation device)

18. Reversibility testing Short acting  2 agonist

19. Bronchodilators FEV 1 FVC PEF 2.61 5.25 6.49 Pre + 12-15 % in FEV1 > 200ml improvement is considered significant 3.95 6.08 9.64 51% 16% 49% Post  2 6 10 246 Vol ( L ) Flow (L/s )

20. Reversibility Testing Airflow obstruction disappears: REVERSIBLE OBSTRUCTION (probably asthma) Airflow obstruction remains: IRREVERSIBLE OBSTRUCTION (probably COPD)

21. A children’s game?

22. But needs a maximal effort

23. Where can I get spirometry? Hospital services Pneumologist Many general practitioners new technique for primary care Lung function lab

24. Telemedicine?

25. Know your numbers! Blood pressure Cholesterol and glycemia FEV1 [= ESW = VEMS] and FVC [= (geforceerde) vitale capaciteit ] [= capacité vitale (forcée)]

26. SPIROMETRY Is a safe and simple test Provides useful data Is underused until now… Blow to know !