SPIROMETRI

INDIKASI SPIROMETRI
• Diagnostik – pada pasien dengan gejala
• Penyaring – pada pasien dengan faktor risiko
• Pemantauan – pada pasien yang mendapat
terapi
• Evaluasi kecacatan/kelumpuhan – untuk
pasien dengan indikasi rehabilitasi, pre
operasi, kepentingan asuransi/hukum
• Kesehatan masyarakat – survei epidemiologis
 KONTRAINDIKASI
• Absolut:
– Peningkatan tekanan intrakranial
– Space occupying lesion di otak
– Ablasio retina
• Relatif:
– Hemoptisis yang tidak diketahui penyebab
– Pneumotoraks
– Angina pektoris tidak stabil
– Hernia – skrotalis, inguinalis, umbilikalis
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• Forced Vital Capacity (FVC)

Vlume of air that can forcibly be blown out after full inspiration, measured in litres.

• Forced expiratory volume in 1 second (FEV1)

FEV1 is the volume of air that can forcibly be blown out in one second, after full
inspiration.
Values depend mainly on sex and age, according to the diagram at left.
Values of between 80% and 120% of the average value are considered normal.

• FEV1/FVC ratio (FEV1%)

FEV1/FVC (FEV1%) is the ratio of FEV1 to FVC.
In healthy adults this should be approximately 75–80%.
Spirometri
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Classification Of Ventilatory Abnormalities by Spirometry
OBSTRUCTIVE RESTRICTIVE MIXED

↓
FEV1 ↓ ↓
or Normal

↓
FVC ↓ ↓
or Normal

Normal or
FEV1/FVC ↓ ↓
↑
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• Obstructive disorder:
FEV1 reduced (<80% predicted normal)
FVC normal or reduced
FEV1 / FVC ratio reduced (<75%)

• Restrictive disorder:
FEV1 reduced normal, or reduced
FVC reduced (<80% predicted normal)
FEV1 / FVC ratio normal (>80%)
Normal Spirometry
A normal flow-volume loop:

A normal volume-time loop:

Obstructive Lung Disease
In patients with obstructive lung disease, the small airways are partially obstructed by
a pathological condition. The most common forms are asthma and COPD.
A patient with obstructive lung disease typically has a concave F/V loop.

Flow-volume in obstructive lung disease:

is concave, FEF25-75 too low, FVC normal
Obstructive Lung Disease
The FET (Forced Expiratory Time) will be higher due to the lower flow but equal
volume.
A Tiffeneau index (FEV1/FVC x 100) of less than 70% is very suggestive for
obstructive lung disease.
A bronchodilator test will be necessary for a more accurate diagnosis.( obtruksi)

Volume-time curve in obstructive lung disease: FEV1 low, FET higher

Restrictive Lung Disease
Restrictive lung disease means that the total lung volume is too low.
Since the airways are normal, the flow volume loop will have a normal shape: the
curve will descend in a straight line from the PEF to the X-axis.

Flow-volume in restrictive lung disease:

shape normal, FVC low
Restrictive Lung Disease
Total lung volume is low, which results in a low FVC. PEF can be normal or low.
FEV1 is equally lowered than FVC, so the Tiffeneau index will be normal or
even raised.

Volume-time curve in restrictive lung disease:

FEV1 too low, FET normal
Mixed Lung Disease
Often patients will show signs of both obstructive and restrictive lung disease.
The flow-volume loop will have characteristics of both syndromes.

Volume-time curve in mixed lung disease:

FVC, FEV1 and FEF25-75 too low
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