Master pulmonary function testing procedures — and prepare for PFT credentialing exams! Ruppel's Manual of Pulmonary Function Testing, 12th Edition provides comprehensive coverage of common pulmonary function tests, testing techniques, and the pathophysiology that may be evaluated by each test. It also includes information on equipment, measurement software, reference values, and quality assurance, so you can develop the testing skills you need to find and assess lung abnormalities and conditions such as asthma, COPD, and emphysema. Written by Carl D. Mottram, a well-known expert in pulmonary function procedures, this bestselling guide helps you get accurate test results every time.
Key Features
New to this Edition
Key Features
- Entry- and Advanced-Level objectives prepare you for success on the NBRC’s Pulmonary Function Technologist credentialing examinations and follow the content guidelines of the CPFT and RPFT exam matrices from the National Board for Respiratory Care.
- How To boxes provide step-by-step guidelines to performing pulmonary function tests, taking the guesswork out of completing accurate and result-producing tests.
- Case studies provide problem-solving challenges for real-life patient scenarios, including each case history, PFT testing results, a technologist’s comments, and questions and answers.
- PFT Tips highlight and reinforce the most important pulmonary function testing information in every chapter.
- Convenient study features include key terms, chapter outlines, learning objectives, chapter summary points, suggested readings, a glossary, and self-assessment questions.
- Authoritative, all-in-one resource eliminates the need to search for information in other sources.
- Criteria for acceptability and repeatability are included in each test section, as well as interpretive strategies to help you adhere to recognized testing standards.
New to this Edition
- NEW! Indications for Pulmonary Function Testing chapter Includes updates in alignment with the 2019 ATS-ERS Spirometry Standards.
- NEW! Spirometry chapter adds updated Information per the new 2019 ATS-ERS Spirometry Technical Standard.
- NEW! Diffusing Capacity Tests chapter is aligned with the 2014 ERS-ATS Technical Standard and the 2017 Global Lung Initiative (GLI) DLCO reference set.
- NEW! Bronchoprovocation Challenge Testing chapter is updated with the 2017 ERS Methacholine Challenge Technical Standard and 2018 ERS Indirect Bronchial Challenge Testing (e.g., mannitol, exercise, hyperventilation, cold air).
- NEW! Specialized Test Regimens chapter includes 2018 ATS Reference Values in Children.
- NEW! Pulmonary Function Testing Equipment chapter is updated with new equipment and vendors.
- NEW! Quality Systems in the Pulmonary Function Laboratory chapter is updated with the newest version of the Clinical and Laboratory Standards Institutes (CLSI) Quality Management System (QMS01), which is the basis for any laboratory quality program, and a new table of recommended target CVs for Biological control (BioQC).
- NEW! Reference Values and Interpretation Strategies chapter adds new GLI (Global Lung Function Initiative) reference sets for Diffusing of the Lung and Lungs Volumes.
Indice testuale
Chapter 1: Indications for Pulmonary Function Testing
Pulmonary function tests
Indications for pulmonary function testing
Patterns of impaired pulmonary function
Preliminaries to patient testing
Test performance and sequence
Summary
Case study
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Indications for Pulmonary Function Testing
Patterns of Impaired Pulmonary Function
Preliminaries to Patient Testing
Chapter 2: Spirometry
Vital Capacity
Forced Vital Capacity, Forced Expiratory Volume, and Forced Expiratory Flow
Flow-Volume Curve
Peak Expiratory Flow
Maximum Voluntary Ventilation
Bronchodilator Responsiveness Testing
Summary
Case Studies
Self-Assessment Questions
Entry-Level
Advanced
Selected bibliography
General References
Spirometry
Peak Expiratory Flow
Before- and After-Bronchodilator Studies
Flow-Volume Curves
Standards and Guidelines
Chapter 3: Diffusing Capacity Tests
Carbon monoxide diffusing capacity
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Dlcosb
Dlcorb
Dlcoib
Standards and Guidelines
Chapter 4: Lung Volumes, Airway Resistance, and Gas Distribution Tests
Lung Volumes: Functional Residual Capacity, Residual Volume, Total Lung Capacity, And Residual Volume/Total Lung Capacity Ratio
Airway Resistance and Conductance
Gas Distribution Tests: Single-Breath Nitrogen Washout, Closing Volume, and Closing Capacity
Multiple-Breath Nitrogen Washout, Lung Clearance Index, And Phase III Slope Analysis
Summary
Case Studies
Self-Assessment Questions
Entry-Level
Selected bibliography
General References
Spirometry and Lung Volumes
Plethysmographic Lung Volumes
Airway Resistance
Gas Dilution Lung Volumes
Gas Distribution
Standards and Guidelines
Chapter 5: Ventilation and Ventilatory Control Tests
Tidal volume, rate, and minute ventilation
Respiratory dead space and alveolar ventilation
Ventilatory response tests for carbon dioxide and oxygen
High-altitude simulation test
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Ventilation
Control of Ventilation
High-Altitude Simulation Test (or Hypoxic Inhalation Test)
Chapter 6: Blood Gases and Related Tests
PH
Carbon dioxide tension
Oxygen tension
Hemoximetry
Pulse oximetry
Capnography
Shunt calculation
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Blood Gases
Pulse Oximetry
Capnography
Shunt Calculation
Standards and Guidelines
Chapter 7: Cardiopulmonary Exercise Testing and Field Tests
Field tests
Exercise protocols and reference sets
Exercise workload
Cardiovascular monitors during exercise
Ventilation during exercise
Oxygen consumption, carbon dioxide production, and respiratory exchange ratio during exercise
Exercise blood gases
Cardiac output during exercise
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Six-Minute Walk Test
Reference Equations
Cardiovascular Monitoring During Exercise
Ventilation, Gas Exchange, and Blood Gases
Standards and Guidelines
Chapter 8: Pediatric Pulmonary Function Testing
Infant, toddler, and preschool pulmonary function testing
Spirometry
Diffusion capacity
Respiratory muscle strength
Lung volumes
Bronchoprovocation challenges
Pulmonary exercise stress testing
Exhaled nitric oxide and nasal nitric oxide
Reference sets and predicted values for pediatrics
Arterial blood gases
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
Spirometry
Predicted Values and Reference Equations
Vocal Cord Dysfunction and Obstructing Upper Airway Lesions
Respiratory Muscle Strength
Exercise Stress Testing
Pulmonary Function Testing in Infants and Very Young Children
Oscillometry and Nitric Oxide
Standards and Guidelines
General References
Chapter 9: Bronchoprovocation Challenge Testing
Bronchoprovocation challenge testing
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
Bronchial Challenge
Guidelines and Standards
Chapter 10: Specialized Tests and Evaluations
Respiratory muscle strength testing
Exhaled nitric oxide
Forced oscillation technique
Preoperative pulmonary function testing
Pulmonary function testing for social security disability
Metabolic measurements: indirect calorimetry
Summary
Case studies
Self-Assessment Questions
Entry-level
Advanced
Selected bibliography
Respiratory Muscle Strength Testing
Exhaled Nitric Oxide
Forced Oscillation Technique
Preoperative Pulmonary Function Testing
Respiratory Impairment for Disability
Metabolic Measurements: Indirect Calorimetry
Guidelines and Standards
Chapter 11: Pulmonary Function Testing Equipment
Volume-displacement spirometers
Flow-sensing spirometers
Peak flowmeters
Body plethysmographs
Breathing valves
Pulmonary gas analyzers
Blood gas analyzers, oximeters, and related devices
Computers for pulmonary function testing
Summary
Self-Assessment Questions
Entry-Level
Advanced
Selected bibliography
Spirometers
Peak Flowmeters
Plethysmographs
Gas Analyzers
Blood Gas Electrodes, Oximeters, and Related Devices
Computers
Chapter 12: Quality Systems in the Pulmonary Function Laboratory
Quality manual
Quality system essentials
Path of workflow
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Standards and Guidelines
Calibration and Quality Control
Chapter 13: Reference Values and Interpretation Strategies
Selecting and using reference values
Establishing what is abnormal
Pulmonary function testing interpretation—“bringing it all together”
Interpretation algorithm
Summary
Case studies
Self-Assessment Questions
Entry-level
Advanced
Selected bibliography
General
Spirometry
Lung Volumes
Diffusing Capacity
Appendix A: Answers to Self-Assessment Questions
Chapter 1, Indications for Pulmonary Function Testing
Chapter 2, Spirometry
Chapter 3, Diffusing Capacity Tests
Chapter 4, Lung Volumes, Airway Resistance, and Gas Distribution Tests
Chapter 5, Ventilation and Ventilatory Control Tests
Chapter 6, Blood Gases and Related Tests
Chapter 7, Cardiopulmonary Exercise Testing and Field Tests
Chapter 8, Pediatric Pulmonary Function Testing
Chapter 9, Bronchoprovocation Challenge Testing
Chapter 10, Specialized Tests and Evaluations
Chapter 11, Pulmonary Function Testing Equipment
Chapter 12, Quality Systems in the Pulmonary Function Laboratory
Chapter 13, Reference Values and Interpretation Strategies
Pulmonary function tests
Indications for pulmonary function testing
Patterns of impaired pulmonary function
Preliminaries to patient testing
Test performance and sequence
Summary
Case study
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Indications for Pulmonary Function Testing
Patterns of Impaired Pulmonary Function
Preliminaries to Patient Testing
Chapter 2: Spirometry
Vital Capacity
Forced Vital Capacity, Forced Expiratory Volume, and Forced Expiratory Flow
Flow-Volume Curve
Peak Expiratory Flow
Maximum Voluntary Ventilation
Bronchodilator Responsiveness Testing
Summary
Case Studies
Self-Assessment Questions
Entry-Level
Advanced
Selected bibliography
General References
Spirometry
Peak Expiratory Flow
Before- and After-Bronchodilator Studies
Flow-Volume Curves
Standards and Guidelines
Chapter 3: Diffusing Capacity Tests
Carbon monoxide diffusing capacity
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Dlcosb
Dlcorb
Dlcoib
Standards and Guidelines
Chapter 4: Lung Volumes, Airway Resistance, and Gas Distribution Tests
Lung Volumes: Functional Residual Capacity, Residual Volume, Total Lung Capacity, And Residual Volume/Total Lung Capacity Ratio
Airway Resistance and Conductance
Gas Distribution Tests: Single-Breath Nitrogen Washout, Closing Volume, and Closing Capacity
Multiple-Breath Nitrogen Washout, Lung Clearance Index, And Phase III Slope Analysis
Summary
Case Studies
Self-Assessment Questions
Entry-Level
Selected bibliography
General References
Spirometry and Lung Volumes
Plethysmographic Lung Volumes
Airway Resistance
Gas Dilution Lung Volumes
Gas Distribution
Standards and Guidelines
Chapter 5: Ventilation and Ventilatory Control Tests
Tidal volume, rate, and minute ventilation
Respiratory dead space and alveolar ventilation
Ventilatory response tests for carbon dioxide and oxygen
High-altitude simulation test
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Ventilation
Control of Ventilation
High-Altitude Simulation Test (or Hypoxic Inhalation Test)
Chapter 6: Blood Gases and Related Tests
PH
Carbon dioxide tension
Oxygen tension
Hemoximetry
Pulse oximetry
Capnography
Shunt calculation
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Blood Gases
Pulse Oximetry
Capnography
Shunt Calculation
Standards and Guidelines
Chapter 7: Cardiopulmonary Exercise Testing and Field Tests
Field tests
Exercise protocols and reference sets
Exercise workload
Cardiovascular monitors during exercise
Ventilation during exercise
Oxygen consumption, carbon dioxide production, and respiratory exchange ratio during exercise
Exercise blood gases
Cardiac output during exercise
Summary
Case studies
Self-Assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Six-Minute Walk Test
Reference Equations
Cardiovascular Monitoring During Exercise
Ventilation, Gas Exchange, and Blood Gases
Standards and Guidelines
Chapter 8: Pediatric Pulmonary Function Testing
Infant, toddler, and preschool pulmonary function testing
Spirometry
Diffusion capacity
Respiratory muscle strength
Lung volumes
Bronchoprovocation challenges
Pulmonary exercise stress testing
Exhaled nitric oxide and nasal nitric oxide
Reference sets and predicted values for pediatrics
Arterial blood gases
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
Spirometry
Predicted Values and Reference Equations
Vocal Cord Dysfunction and Obstructing Upper Airway Lesions
Respiratory Muscle Strength
Exercise Stress Testing
Pulmonary Function Testing in Infants and Very Young Children
Oscillometry and Nitric Oxide
Standards and Guidelines
General References
Chapter 9: Bronchoprovocation Challenge Testing
Bronchoprovocation challenge testing
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
Bronchial Challenge
Guidelines and Standards
Chapter 10: Specialized Tests and Evaluations
Respiratory muscle strength testing
Exhaled nitric oxide
Forced oscillation technique
Preoperative pulmonary function testing
Pulmonary function testing for social security disability
Metabolic measurements: indirect calorimetry
Summary
Case studies
Self-Assessment Questions
Entry-level
Advanced
Selected bibliography
Respiratory Muscle Strength Testing
Exhaled Nitric Oxide
Forced Oscillation Technique
Preoperative Pulmonary Function Testing
Respiratory Impairment for Disability
Metabolic Measurements: Indirect Calorimetry
Guidelines and Standards
Chapter 11: Pulmonary Function Testing Equipment
Volume-displacement spirometers
Flow-sensing spirometers
Peak flowmeters
Body plethysmographs
Breathing valves
Pulmonary gas analyzers
Blood gas analyzers, oximeters, and related devices
Computers for pulmonary function testing
Summary
Self-Assessment Questions
Entry-Level
Advanced
Selected bibliography
Spirometers
Peak Flowmeters
Plethysmographs
Gas Analyzers
Blood Gas Electrodes, Oximeters, and Related Devices
Computers
Chapter 12: Quality Systems in the Pulmonary Function Laboratory
Quality manual
Quality system essentials
Path of workflow
Summary
Case studies
Self-assessment questions
Entry-Level
Advanced
Selected bibliography
General References
Standards and Guidelines
Calibration and Quality Control
Chapter 13: Reference Values and Interpretation Strategies
Selecting and using reference values
Establishing what is abnormal
Pulmonary function testing interpretation—“bringing it all together”
Interpretation algorithm
Summary
Case studies
Self-Assessment Questions
Entry-level
Advanced
Selected bibliography
General
Spirometry
Lung Volumes
Diffusing Capacity
Appendix A: Answers to Self-Assessment Questions
Chapter 1, Indications for Pulmonary Function Testing
Chapter 2, Spirometry
Chapter 3, Diffusing Capacity Tests
Chapter 4, Lung Volumes, Airway Resistance, and Gas Distribution Tests
Chapter 5, Ventilation and Ventilatory Control Tests
Chapter 6, Blood Gases and Related Tests
Chapter 7, Cardiopulmonary Exercise Testing and Field Tests
Chapter 8, Pediatric Pulmonary Function Testing
Chapter 9, Bronchoprovocation Challenge Testing
Chapter 10, Specialized Tests and Evaluations
Chapter 11, Pulmonary Function Testing Equipment
Chapter 12, Quality Systems in the Pulmonary Function Laboratory
Chapter 13, Reference Values and Interpretation Strategies
