Saturday, February 22, 2014

Measuring Breathlessness With A Spirometer

By Serena Price


Shortness of breath is one of the main complaints that sends people to the doctor's office. One of the tools used to help diagnose the cause of breathlessness is called a spirometer. This is a kind of pulmonary function monitor (PFM) and measures the volume of air inspired and expired through the lungs. The printed output from the device is a graph, and this can indicate whether the breathing dysfunction is restrictive or obstructive. Spirometers are constructed differently to enable different strategies for measuring the movement of air (pressure transducers, ultrasound, water gauge).

Lung function tests are utilized to eliminate the presence of serious pulmonary conditions such as asthma, emphysema and bronchitis. They are also performed to assess the influence on the lungs of medications or ambient contaminants, to help determine the cause of breathlessness and to evaluate the progress of treatments. Lung function tests are also performed before surgery on the lungs to take benchmark measurements of lung activity.

It was Claudius Galen, noted Roman physician, who devised the first PFM and conducted the first lung function tests. This took place in the late first or early second century AD. Later instruments were based on a bell jar turned upside down in water. Modern variants include the whole body plethysmograph, peak flow meter and the pneumotachometer.

Most causes of shortness of breath are benign and easily reversible. First, it is essential to rule out more sinister causes. The Mayo Clinic defines shortness of breath as a severe tightening of the chest and a sensation of being suffocated. There may be a single episode or there may be a pattern of episodes.

Along with instrumentation, there are a half dozen or more so-called "red flag" symptoms and signs that may herald a serious lung condition. These include persistent pallor and fatigue, swollen ankles, a chronic wheeze or cough, having a hard time breathing when lying flat, pain worsening with activity, or any other persistent or strange symptoms. A history of working in an environment where there is asbestos, wood dust, hazardous chemical fumes or in a coal mine might also contribute to a lung disorder.

Asthma, a chronic disease of the airways, is somewhat more serious. According to the Centers for Disease Control in Atlanta, Georgia, 18.9 million non-institutionalized adults have asthma at any one time. This represents 8.2 percent of that population.

Once any serious cause has been ruled out, most cases of breathlessness are related to one of two causes, bad respiratory habits and weak muscles; or trigger points, or muscle knots. These are both minor and easily treatable. The treatment is safe, free and almost fun. It consists of identifying and massaging trigger points.

A spirometer is an instrument that has been in use for two millennia to detect the cause of breathlessness. It can determine whether it is present and identify whether it is restrictive or obstructive but requires further investigations to rule out the presence of any serious conditions, such as emphysema, asthma or bronchitis. Once these have been eliminated from consideration, they may be attributable to either trigger points or incorrect breathing patterns.




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