RESPIRATION PHYSIOLOGY
Evaluation of Respiratory Function Tests

Evaluation of Respiratory Pathophysiology from Pulmonary Function Tests and Blood Gas Analysis

PROBLEM DIAGNOSIS
Low Inspired Oxygen PI-O2 (dry) << 160 mmHg or PI-O2 (wet) << 150 mmHg
Hypoventilation PA-CO2 >> 40 mmHg;  also PA-O2 << 100 mmHg
    Restrictive TLC << predicted
    Obstructive FEV1/VC << 80% or (if not Restrictive) PEF << predicted
    Neurogenic Maximum pressure << 100 cmH2O (neuromuscular problem) or V'E low even though no restrictive or obstructive disease (CNS problem)
Alveolar-Arterial Equilibration AaDO2 (PA-O2 - Pa-O2) >> 5 mmHg (may need to use the alveolar air equation to calculate PA-O2)
    Diffusion Limitation DCO << predicted
    Shunt When inspiring pure oxygen, Pa-O2 << 570 mmHg or %Shunt >> 5%
    V'A/Q mismatch On nitrogen washout, N2% increase >> 1.5%;  non-uniform distribution on radioactive tracer scan
Anemia Hb << 150 gm/liter (15 gm/dl);  Ca-O2<< expected from Pa-O2 or Sa-O2 (% saturation)
Low Cardiac Output O2 extraction (Ca-O2 - Cv-O2) >> 50 ml-O2/liter (5 ml/dl) at rest

predicted means predicted from patient's age, size, and sex

<< means significantly less than

>> means significantly greater than