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Pulmonary Test Interpretation


HeathrowMan

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I had a pulmonary test and I don't know what it means

using the machine it said my FVC 74.4, FEV1 75.0, FEF25 - 75 = 73.5, FEV1/FVC % = 79

After Bronchodilator

FVC 72.7, FEV1 75.5, FEF25 - 75 = 83.7,FEV1/FVC % = 82

Interpretation: No obstructive lung defect indicated by the FEV1/FVC. There is a moderate restrictive lung defect. There is a decrease in diffusing capacity. FEF 25-75 changed by 14%. This is interpreted as an insignificant response to bronchodilator.

What is this telling me ?

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I had a pulmonary test and I don't know what it means

using the machine it said my FVC 74.4, FEV1 75.0, FEF25 - 75 = 73.5, FEV1/FVC % = 79

Your pulmonary function tests are showing impairmnent in your lung function.

After Bronchodilator

FVC 72.7, FEV1 75.5, FEF25 - 75 = 83.7,FEV1/FVC % = 82

Interpretation: No obstructive lung defect indicated by the FEV1/FVC.

It isn't showing an OBSTRUCTIVE PATTERN

There is a moderate restrictive lung defect.

It IS showing a MODERATE RESTRICTIVE PATTERN

There is a decrease in diffusing capacity.

FEF 25-75 changed by 14%. This is interpreted as an insignificant response to bronchodilator.

The problem isn't helped by using bronchodialtor medicine.

What is this telling me ?

http://en.wikipedia.org/wiki/Respiratory_disease

Obstructive lung disease

Emphysema

Bronchitis

Asthma

Chronic obstructive pulmonary disease (COPD)

Bronchiectasis

Byssinosis

Bronchiolitis

Asbestosis

Obstructive disease is characterized by an increase in airway resistance that is measured as a decrease in peak expiratory flow rates. In some cases, there is a miss-match between the FEV1/FVC ratio. The normal person exhales most of the inspired air in the 1st second; this ratio on normal subjects is around 0.8, this means that 80% of the expired air is expelled the 1st second.

[edit] Restrictive lung diseases

Fibrosis

Sarcoidosis

Alveolar Damage

Pleural effusion

Hypersensitivity pneumonitis

Asbestosis

Pleurisy

Lung Cancer

This pattern is characterized by an increase of the force trying to collapse the lung (recoil) and a decrease in lung compliance, measured as a decrease in all lung volumes. This is opposed to Obstructive in which you only have an increment of the values that take in to notice Residual Volumes (RV) such as TLC (Total Lung Capacity) and FRC (Functional Residual Capacity). In this case TLC is smaller than normal since the recoil force in the lung is greater than what it should be, the FEV1/FVC ratio will also be altered but instead of being lower than normal it will be higher than normal.

As previously stated FEV1/FVC should be around 0.8, in Obstructive Disease is lower, in Restrictive Disease since the amount of air going in is a lot less than in a normal or an obstructive pattern, the ratio appears to be higher (more than 80%) this is because a the smaller volume is expired quickly and more completely than in a normal pattern

http://www.nlm.nih.gov/medlineplus/ency/article/003854.htm

Diffusing capacity; DLCO test

Definition

Lung diffusion testing is used to determine how well oxygen passes from the air sacs of the lungs into the blood. The test measures the "diffusing capacity of the lung for carbon monoxide" or DLCO.

How the test is performed

You breath in (inhale) some gas containing a very small quantity of carbon monoxide, hold your breath for 10 seconds, then rapidly blow it out (exhale). The single exhaled gas is analyzed to determine how much carbon monoxide was absorbed during the breath.

Why the test is performed

The test is used to diagnose the presence and extent of certain lung diseases. It may also be used to see how gases move the lungs into the bloodstream.

What abnormal results mean

Abnormal results generally mean that gases do not move normally across the lung tissues. This may mean that lung diseases, such as interstitial fibrosis, sarcoidosis, asbestosis, and emphysema, are present.

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You can find §4.97 Schedule of ratings—respiratory system. - at this link

http://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_97.DOC

That will show more what these numbers mean in relation to percent of disability within the VA rating system.

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I have paralyzed diaphragm from a neck injury. I have a moderate to severe restriction with pulmonary hypertension. .

What is your diffusion capacity? and have you ever been diagnosed with pulmonary hypertension.

Pulmonary hypertension associated with lung disease is a 100 percent rating regardless of the lung volumes.

Restrictive Lung Disease

6840 Diaphragm paralysis or paresis.

6841 Spinal cord injury with respiratory insufficiency.

6842 Kyphoscoliosis, pectus excavatum, pectus carinatum.

6843 Traumatic chest wall defect, pneumothorax, hernia, etc.

6844 Post-surgical residual (lobectomy, pneumonectomy, etc.).

6845 Chronic pleural effusion or fibrosis.

General Rating Formula for Restrictive Lung Disease (diagnostic codes 6840 through 6845):

FEV–1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV–1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy 100

FEV–1 of 40- to 55-percent predicted, or; FEV–1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit) 60

FEV–1 of 56- to 70-percent predicted, or; FEV–1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted 30

FEV–1 of 71- to 80-percent predicted, or; FEV–1/FVC of 71 to 80 percent, or; DLCO (SB) 66

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I currently am rated 10% Hypertension, 10% heart condition and 50% sleep apnia. My diffusion method reads DLCO-SB L 33.43 18.70 55.9 25.23

In addition chest xray showed a vague new modular density measuring approximately 4 mm in the right upper lobe. Cat scan reading was benign but I mst go back in 3 months, 6 months 12 months and 24 months.

I worked in the Pentagon for eleven years as well as a tropo site where my office was inside the comm/power plant office.

I don't know if I was exposed to anything at the tropo site but the Pentagon did go through renovation because of asbestos.

Have I been exposed to anything that may put me in harms way and should I put in a claim based on these results. I now have a slight cough. Any help would be appreciated.

Edited by HeathrowMan
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The VA Examiner who did my PFT told me I had Sleep Apnea, I already knew but it blew me away he knew. He showed me a little flat spot in the graph printout and said thats how I know. I am still waiting for the VA to adjudicate my claim for asbestosis/restrictive lung disease. I found out recently they were waiting on a VCAA Election form b4 adjudicating my claim.

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