That “wonderful” moment came when my allergy mutated into something incredible. Now, having entered a room where not only there is, but once there was (!) a cat, I begin to choke. My breathing turns into wheezing, there is not enough air, it seems that my consciousness is about to pass out and I will go to my forefathers. All antihistamine tablets I know do not help. But such a reaction only for cats.

The prospect of a premature departure to another world is not the most rosy, I had to go to an allergist. In addition to a bunch of various tests, tests and tons of money spent, I was prescribed a strange procedure called FVD (function of external respiration) or spirogram.

I was assigned FVD + bronchodilator.

Study of external respiratory function (PRF) Study of external respiratory function is a set of diagnostic procedures and tests that are used to diagnose diseases of the lungs and bronchi. Gas exchange between external air and blood occurs in the lung tissue.

I don’t know how things are with medicine in other cities, but to the shame of Voronezh, everything is very bad here. Or maybe I'm unlucky.

Having visited a free allergist and spent the whole day in line, despite the coupon with the appointed time, I only heard from the doctor a recommendation to visit her paid clinic and received a receipt for payment for tests that must be done in the same clinic. That's all. The appointment lasted 5 minutes.

Having learned from bitter experience, I went to a personally selected paid clinic, to a doctor with good reviews, hopefully not obtained through QComment.

Actually, that’s why the lung diagnostic procedure was paid. The cost was 1150 rubles.

FVD - what is this procedure?

Her goal find out if the patient has bronchial asthma, chronic obstructive pulmonary disease or any other deviations of the respiratory system.

the study allows you to find out how much air the subject can inhale and exhale and at what speed he is able to do this.

If everything is clear with this, because... you will have to breathe into a special apparatus, which can record the volume of your lungs. But how are deviations identified, i.e. The research system itself remains a mystery to me. It's a pity that I'm not a doctor!...

The results of spirometry change in a number of other diseases of the respiratory, cardiovascular, nervous systems and musculoskeletal system, characterizing their effect on the breathing of the subject.

How to prepare for the procedure?

Naturally, the first thing I did was go online to read what kind of execution this was, whether it hurt, whether it was scary, and what to be prepared for.

The information given is different everywhere: somewhere it says that you should do it on an empty stomach, or not eat 4-5 hours in advance, somewhere it says not to drink coffee or smoke the day before.

Also, be sure to take it with you fluorography.

About the procedure.

They say that you need to sit quietly half an hour before the FVD, breathe some air, calm down and warm your hands.

But I'm lucky! Having dealt with all the traffic jams on the way to the clinic and being nervous, I still made it on time. Muchoy went up to the third floor to the desired office. She even arrived about 10 minutes earlier than expected. The office door was closed, there were no patients for the same procedure.

I waited half an hour, went downstairs to the reception desk, to find out who ate my doctor, maybe he was sucked in by the terrible machine? Or was he tired of working and decided that today was the best day for a strike?

Well, the devil knows. Why write the time on tickets at all if no one looks at them? And okay in free ones, but in paid ones! sorry for this cry from the heart

The receptionist said that the doctor was not seen running away from the clinic. So, it’s still there, just hiding somewhere. I was satisfied with the answer. I went back to the third floor. And what?! There's already a line in front of the office! And, naturally, no one looked at the time tickets!

It happened in Diagnostics Plus, on Moskovsky Prospekt.

It's finally my turn (an hour has passed)

I was asked about age, weight and height. And we began the spirometry procedure.

The device is a small box with a hose into which you blow. Each patient is given an individual nozzle, which after use is dipped into the disinfection solution.

So, a kind of clothespin is put on the nose, the lips are tightly wrapped around the tube and inhalations and exhalations are made. That's the whole procedure.

Total was done 6 approaches.

1. Inhale the air deeply and exhale calmly.

2. Inhale air and exhale as long as possible.

3. Inhale air and exhale as quickly as possible.

I have had FVD with bronchodilator- this means, as the doctor explained, the allergist wanted to identify the lungs’ reaction to the medicine: positive or negative.

I was given a can Salbutamol for two inhalations. (Actually I need 4, but I’m light). After which I was sent into the corridor to wait for 20 minutes.

By the way, Salbutamol has a number of contraindications, which the doctor performing the procedure did not mention!

Hypersensitivity, pregnancy (when used as a bronchodilator), breastfeeding, children's age (up to 2 years - for oral administration and for metered-dose aerosol without a spacer, up to 4 years - for powder for inhalation, up to 18 months - for solution for inhalation). For intravenous administration as a tocolytic (optional): infections of the birth canal, intrauterine fetal death, fetal malformations, bleeding with placenta previa or premature placental abruption; threatened miscarriage (in the 1st–2nd trimester of pregnancy).

I had a strange reaction to the drug - I began to feel a little dizzy, and when I stood up, I felt a tremor in my arms and legs. The lousy feeling stopped as soon as I went out into the fresh air.

After which the 3 procedures described above were repeated.

They immediately gave us a conclusion - an A4 sheet with graphs on both sides.

The conclusion says that I have a negative test for Salbutamol. This means that there is no obstruction in the lungs, which is actually good. If the result was positive, it would indicate the possibility of asthma or some other change.

By the way, the diagnosis states that I have “impaired bronchial obstruction” - the device recorded my forced “communication” with the cat three days ago.

Decoding FVD.

Only a doctor can do a complete and thorough analysis of the charts. Good doctor.

But you can understand the approximate situation yourself: next to your indicators there will be a norm by which you can compare the data.

My allergist, after looking at the results, diagnosed me with bronchial asthma. But I recently visited a pulmonologist, who did not say a word about any changes in the lungs.

I went to another allergist, who rejected this diagnosis, added some other tests and recommended redoing the FVD.

Well, and finally.

They didn’t even ask me about the fluorogram! And when I reminded myself of it, the doctor said that she only asks it to older people. WTF?! Young people don’t get sick, or what?! And it’s unlikely that a disposable mouthpiece can save you from tuberculosis.

I give the procedure itself five stars and recommend it. But I don’t advise Voronezh residents to undergo it at Diagnostics Plus.

FVD study is a simple and informative way to assess the activity of the respiratory system. If a person suspects a disorder, the doctor suggests that he undergo functional diagnostics.

What is FVD? In what cases is it done to an adult and a child?

FVD is a set of studies that determine the ventilation capacity of the lungs. This concept includes the total, residual volume of air in the lungs, the speed of air movement in different sections. The obtained values ​​are compared with the statistical average, based on this, conclusions are drawn about the patient’s health status.

The examination is carried out to obtain average statistical data on the health of the population in the region, to monitor the effectiveness of therapy, dynamic monitoring of the patient’s condition and the progression of pathology.

The patient can find out what it is when a number of complaints appear:

• attacks of suffocation;
• chronic cough;
• frequent incidence of respiratory diseases;
• if shortness of breath appears, but cardiovascular pathologies are excluded;
• cyanosis of the nasolabial triangle;
• when foul-smelling sputum with pus or other inclusions appears;
• if there are laboratory signs of excess carbon dioxide in the blood;
• the appearance of chest pain.

The procedure is prescribed without complaints for chronic smokers and athletes. The first category becomes prone to diseases of the respiratory system. The second resorts to spirometry to assess how much reserve the system has. Thanks to this, the maximum possible load is determined.

Before surgery, respiratory function and evaluation of the results helps to get an idea of ​​the localization of the pathological process and the degree of respiratory failure.

If a patient is examined for disability, one of the stages is an examination of the respiratory system.

What disorders of the respiratory system and lungs does the examination show?

Impaired respiratory function occurs due to inflammatory, autoimmune, and infectious lesions of the lungs. These include:

• COPD and asthma, confirmed and suspected;
• bronchitis, pneumonia;
• silicosis, asbestosis;
• fibrosis;
• bronchiectasis;
• alveolitis

Features of the FVD method in a child

To test the functioning of the respiratory system, the respiratory function test system includes several types of samples. During the study, the patient must perform several actions. A child under 4-5 years old cannot fully fulfill all the requirements, so FVD is prescribed after this age. The child is explained what he must do, using a playful form of work. When deciphering the results, you may encounter unreliable data. This will falsely declare pulmonary or upper system dysfunction.

Conducting research in children differs from adults, since the anatomical structure of the respiratory system in the pediatric population has its own characteristics.

The initial establishment of contact with the child comes to the fore. Among the methods, you should choose options that are closest to physiological breathing and do not require significant effort from the child.

How to properly prepare for the procedure: algorithm of action

If you need to prepare to examine the external nature of breathing, you do not need to perform complex actions:

• exclude alcoholic drinks, strong tea and coffee;
• a few days before the procedure, limit the number of cigarettes;
• eat a maximum of 2 hours before spirometry;
• avoid active physical activity;
• Wear loose clothing during the procedure.

If the patient has bronchial asthma, then compliance with the requirements of medical personnel may lead to an attack. Therefore, preparation can also be considered a warning about a possible deterioration in health. He should have a pocket emergency inhaler with him.

Is it possible to eat food before the test?

Although the digestive system is not directly connected to the respiratory organs, overeating before an FVD test can cause the stomach to compress the lungs. Digestion of food and its movement through the esophagus reflexively affects breathing, speeding it up. Taking these factors into account, there is no need to abstain from food for 6-8 hours, but you should not eat just before the examination. The optimal time is 2 hours before the procedure.

How to breathe correctly when doing FVD?

In order for the results of an examination of the function of the respiratory system to be reliable, it is necessary to bring it back to normal. The patient is placed on the couch, where he lies for 15 minutes. Methods for studying respiratory function include spirography, pneumotachography, body plethysmography, and peak flowmetry. The use of only one of the methods does not allow us to fully assess the condition of the respiratory system. FVD is a set of measures. But most often the first examination methods from the list are prescribed.

A person's breathing during the procedure depends on the type of examination. In spirometry, the lung capacity is measured by requiring a person to take a normal breath and exhale into the device as during normal breathing.

Pneumotachography measures the velocity of air through the respiratory tract at rest and after exercise. To determine the vital capacity of the lungs, you need to take as deep a breath as possible. The difference between this indicator and lung volume is reserve capacity.

What sensations does the patient experience during the examination?

Due to the fact that during diagnostics the patient is required to use all the reserves of the respiratory tract, slight dizziness may occur. Otherwise, the examination does not cause discomfort.

Diagnosis of the respiratory system using spirography and spirometry

When performing spirometry, the patient sits with his hands on a special place (armrests). The result is recorded using a special device. A hose is attached to the body, with a disposable mouthpiece at the end. The patient puts it in his mouth, and the healthcare worker uses a clamp to close his nose.

The subject breathes for some time, getting used to the changed conditions. Then, at the command of the health worker, he takes a normal breath and releases the air. The second study involves measuring the volume of exhalation after a standard portion is finished. The next measurement is the inspiratory reserve volume; for this you need to draw air as full as possible.

Spirography – spirometry with recording of the result on tape. In addition to a graphical image, system activity is displayed in tangible form. To obtain a result with minimal error, it is taken several times.

Other methods for studying respiratory function

Other methods included in the complex are performed less frequently and are prescribed when spirometry cannot obtain a complete picture of the disease.

Pneumotachometry

This study allows you to determine the speed of air flow through different parts of the respiratory system. It is carried out while inhaling and exhaling. The patient is asked to inhale or exhale as much as possible into the device. Modern spirographs simultaneously record spirometry and pneumotachometry readings. It allows you to identify diseases accompanied by a deterioration in the passage of air through the respiratory system.

Test with bronchodilators

Spirometry does not allow detection of hidden respiratory failure. Therefore, in case of an incomplete picture of the disease, FVD with a test is prescribed. It involves the use of bronchodilators after measurements have been taken without the drug. The interval between measurements depends on which medicinal substance is used. If it is salbutamol, then after 15 minutes, ipratropium - 30. Thanks to testing with bronchodilators
it is possible to determine the pathology at a very early stage.

Lung provocative test

This option for checking the respiratory system is carried out if there are signs of asthma, but the bronchodilator test is negative. The provocation consists of administering methacholine to the patient by inhalation. The concentration of the drug constantly increases, which causes difficulty in the conduction of the respiratory tract. Symptoms of bronchial asthma appear.

Bodyplethysmography

Body plethysmography is similar to previous methods, but it more fully reflects the picture of the processes occurring in the respiratory system. The essence of the study is that a person is placed in a sealed chamber. The actions that the patient must perform are the same, but in addition to the volumes, the pressure in the chamber is recorded.

Ventolin test

This drug belongs to the selective β2-adrenergic receptor agonists, the active substance is salbutamol. When administered after 15 minutes, it provokes dilation of the bronchi. In the diagnosis of asthma, it is essential: the patient is subjected to spirometry, measuring air circulation parameters before and after the drug. If the second sample shows an improvement in ventilation by 15%, the sample is considered positive, from 10% - doubtful, below - negative.

Stress tests

They consist of measuring the performance of the respiratory system at rest and after physical activity. This test allows you to determine the disease of effort, in which coughing begins after exercise. This is often observed in athletes.

Diffusion test

The main function of respiration is gas exchange; a person inhales oxygen needed by cells and tissues and removes carbon dioxide. In some cases, the bronchi and lungs are healthy, but gas exchange, that is, the process of exchanging gases, is disrupted. The test shows this: the patient closes his nose with a clip, inhales a mixture of gases through a mask for 3 seconds, exhales for 4 seconds. The equipment immediately measures the composition of exhaled air and interprets the data obtained.

Decoding of the results of physical activity: table - norms of indicators for men, women and children

Having received the device’s conclusion, you need to analyze the data obtained and draw a conclusion about the presence or absence of pathology. They should only be deciphered by an experienced pulmonologist.
The normal range of indicators is much different, since each person has their own level of physical fitness and daily activity.

Lung volume depends on age: up to 25-28 years, the value of vital capacity increases, by 50 it decreases.

To decipher the data, normal values ​​are compared with those obtained from the patient. For ease of calculation, the values ​​of inhalation and exhalation volumes are expressed as % of the vital capacity of the lungs.

A healthy person should have an FVC volume (forced vital capacity), CVF, Tiffno index (CVF/FVC) and maximum voluntary ventilation (MVV) of at least 80% of the values ​​indicated as the statistical average. If actual volumes decrease to 70%, then this is recorded as a pathology.

When interpreting the results of a stress test, the difference in performance, expressed as a percentage, is used. This allows you to clearly see the difference between the volume and speed of air conduction. The result can be positive, when the patient's condition has improved after administration of the bronchodilator, or negative. In this case, air conduction has not changed; the medicine may negatively affect the condition of the respiratory tract.

To determine the type of air conduction disorder in the respiratory tract, the doctor focuses on the ratio of FEV, VC and MVL. When it is determined whether the ventilation capacity of the lungs is reduced, attention is paid to FEV and MVL.

What equipment and devices are used in medicine to carry out analysis?

To conduct different types of FVD studies, different devices are used:

1. Portable spirometer with thermal printer SMP 21/01;
2. Spirograph KM-AR-01 “Diamant” – pneumotachometer;
3. “Schiller AG” analyzer, it is convenient to use for samples with bronchodilators;
4. The Microlab spiro analyzer has a touch screen; functions are switched by touching the function icon;
5. Portable spirograph "SpiroPro".

This is only a small part of the devices that record external respiration functions. Medical equipment manufacturing companies offer institutions portable and stationary devices. They differ in capabilities, each group has its own advantages and disadvantages. For hospitals and clinics, it is more important to purchase a portable device that can be moved to another office or building.

Will FVD indicate asthma in a child and how?

The patient's main indicators are measured, then their relationship to the norm is determined. A patient with obstructive diseases has a decrease in values ​​below 80% of normal, and the ratio of FEV to FVC (Hensler index) is below 70%.

Asthma is characterized by reversible obstruction of the upper airways. This means that the FEV/VC ratio increases after salbutamol administration. To diagnose asthma, in addition to the respiratory function indicators indicating pathology, the patient must have clinical signs of the disorder.

Research during pregnancy and breastfeeding

When diagnosing diseases, the question always arises whether pregnant and lactating women can be examined. Disturbances in the functioning of external respiration and the system as a whole can be detected during gestation for the first time. Deterioration of the conductivity of the pathways leads to the fact that the fetus does not receive the required amount of oxygen.

The norms prescribed in the tables do not apply to pregnant women. This is due to the fact that to provide the required volume of air to the fetus, the rate of minute ventilation gradually increases, by 70% by the end of the gestational period. Lung volume and expiratory speed are reduced due to compression of the diaphragm by the fetus.

When examining the function of external respiration, it is important to improve the patient’s condition, so if a bronchodilator is required, it is carried out. Tests make it possible to establish the effectiveness of therapy, prevent the development of complications, and begin timely treatment. The method is performed in the same way as in non-pregnant patients.

If the patient has not previously taken medications for the treatment of asthma, then during lactation it is not advisable to use a test with a bronchodilator. If this is necessary, the child is transferred to artificial nutrition for the period of drug removal.

What are the normal parameters of respiratory function in COPD and bronchial asthma?

The 2 disorders differ in that the first refers to irreversible types of airway obstruction, the second to reversible types. When a breathing test is performed, the specialist is faced with the following results for COPD: Vital vital capacity decreases slightly (up to 70%), but the FEV/1 indicator is up to 47%, that is, the disturbances are sharply expressed.

With bronchial asthma, the indicators may be the same, since both diseases are classified as an obstructive type of disorder. But after a test with salbutamol or another bronchodilator, the indicators increase, that is, the obstruction is recognized as reversible. In COPD this is not observed; then FEV is measured in the first second of exhalation, which gives an idea of ​​the severity of the patient’s condition.

Contraindications for the study

There is a list of conditions in which spirometry is not performed:

• early postoperative period;
• violation of cardiac muscle nutrition;
• thinning of the artery with dissection;
• age over 75 years;
• convulsive syndrome;
• hearing impairment;
• mental disorder.

The examination creates a load on the vessels and pectoral muscles, can increase pressure in different parts and cause deterioration in well-being.

Are there possible side effects when performing FVD?

Undesirable effects from the examination are due to the fact that it requires you to quickly exhale into the mouthpiece several times. Due to the excess influx of oxygen, a tingling sensation appears in the head, dizziness, which quickly passes.

If we study the function with a bronchodilator, then its administration provokes several nonspecific reactions: slight tremor of the limbs, a burning sensation or tingling in the head or body. This is due to the complex effect of the drug, which dilates blood vessels throughout the body.

The deterioration of the environmental situation leads to an increase in the proportion of bronchopulmonary diseases of an acute and chronic nature. At the beginning of development, they are secretive in nature and therefore invisible. Medicine has improved the method of studying FVD, thanks to which all data is obtained automatically. Preparation does not take much time, and the patient receives results almost immediately. Every person is interested in taking this study. This can be a guarantee that he is healthy.

For diagnostics, dynamic monitoring of patients and assessment of the effectiveness of therapy, exhalation flow rates are recorded. Such tests are especially useful when the patient has no symptoms of asthma or signs of difficulty breathing.

Airflow speed and lung volume is recorded using spirometry during forced expiration. Limitation of air flow rate in bronchial asthma causes smaller partial lung expiratory volumes. Spirometric normative values ​​for OOB1 have been developed for children of different heights, genders, and ethnicities. The decrease in FEV1, expressed as a percentage of the standard value, is one of four criteria for the severity of bronchial asthma.

Since sick the lungs are usually inflated, often very much, the ratio of FEV1 to FVC allows one to calculate their total expiratory volume. An FEV1/FVC ratio of less than 0.8 usually indicates significant airflow limitation. However, it is impossible to diagnose bronchial asthma solely on the basis of a decrease in air flow velocity, since this is also typical for many other pathological conditions. With bronchial asthma, inhalation of beta-agonists (for example, salbutamol through a nebulizer) dilates the bronchi more strongly than in the absence of asthma; Asthma is characterized by an increase in FEV1 by more than 12%.

It's important to remember that diagnostic value of spirometric data depends on the patient’s ability to perform repeated full and forced exhalations. Children over 6 years of age usually perform this procedure easily. Spirometric data are only meaningful if they are reproducible over the course of the study. If, after three consecutive attempts, FEV1 differs by no more than 5%, then they focus on the best of the three indicators.

For diagnosis of bronchial asthma and to optimize its treatment, provocative tests with narrowing of the bronchi are also used. The airways of patients are hypersensitive and therefore react more strongly to inhalation of methacholine, histamine and cold or dry air. The degree of increased sensitivity of the bronchi to these irritants corresponds to the severity of asthma and inflammation of the airways. Carrying out provocative tests requires careful dosing of stimuli and monitoring of patients. Therefore, such samples are rarely used in practical work.

Exercise test(for example, running for 6-8 minutes) reveals bronchial asthma of physical effort. If in healthy people the functional volume of the lungs increases during exercise, and FEV1 increases slightly (by 5-10%), then untreated bronchial asthma is characterized by a decrease in air flow speed: FEV1 during and after exercise, as a rule, decreases by more than 15% . Bronchospasm usually begins in the first 15 minutes after intense physical activity and disappears spontaneously after 60 minutes. Studies conducted in the USA among school-age children show that exercise testing adds about 10% of previously undiagnosed patients to the number of patients with bronchial asthma.

In patients high risk groups this test can cause a severe asthma attack. Therefore, for such a study it is necessary to carefully select children and be prepared in advance to eliminate the attack.

Exist simple and inexpensive devices for determining peak expiratory volume flow (PEF) at home. The diagnostic value of this indicator is not absolute; in some cases, a decrease in PEEF is recorded only with pronounced bronchospasm. Therefore, it is advisable to determine PEEF in the morning and evening (preferably 3 times) over several weeks in order to master the method of its registration, establish the best personal indicator and identify the relationship of PEEF values ​​with clinical symptoms (and, ideally, with spirometry indicators). Bronchial asthma is characterized by differences between morning and evening PEEF values ​​exceeding 20%.

Radiography for bronchial asthma. An X-ray examination of the chest (in the anterior direct and lateral projections) in children with bronchial asthma often reveals only mild and nonspecific signs of hyperventilation (for example, flattening of the domes of the diaphragm) and increased pulmonary pattern. X-rays help identify changes characteristic of conditions that mimic asthma, such as aspiration pneumonia or increased transparency of the lung fields in bronchiolitis obliterans, as well as complications of asthma itself, such as atelectasis or pneumothorax.

Some changes in the lungs are better visible when High resolution CT. Thus, bronchiectasis, characteristic of cystic fibrosis, allergic bronchopulmonary mycoses (for example, aspergillosis), ciliary dyskinesia, or immunodeficiencies, is sometimes difficult to see on radiographs, but they are clearly visible on scans.

Skin tests help to establish sensitization to air allergens, which contributes to the treatment and prognosis of the course of bronchial asthma. In an extensive study conducted in the United States among children with asthma aged 5-12 years, sensitization to airborne allergens was detected using puncture skin tests in 88% of cases.

Educational video - FVD (spirometry) indicators in health and disease

Doctors often prescribe their patients to undergo an FVD test. What it is? What results are considered normal? What diseases and disorders can be diagnosed using this method? These questions interest many.

FVD - what is it?

FVD is an abbreviation that stands for “function of external respiration.” This study allows you to evaluate the functioning of the respiratory system. For example, with its help, the doctor determines how much air enters the patient’s lungs and how much comes out. In addition, during the test, changes in air flow speed in different parts of the respiratory system can be analyzed. Thus, the study helps to assess the ventilation abilities of the lungs.

The importance of FVD for modern medicine

In fact, the significance of this study is difficult to overestimate. Naturally, it is used to diagnose certain disorders of the respiratory system. But the range of application of the method is much wider. For example, spirometry is a mandatory, routine test for people working in hazardous environments. In addition, the results of this analysis are used for expert assessment of a person’s performance, determining his suitability for work in certain environmental conditions.

The study is used for dynamic observation, as it makes it possible to assess the rate of development of a particular disease, as well as the results of therapy. In some cases, FVD analysis is used to diagnose allergic diseases, because it allows one to trace the effect of a particular substance on the respiratory tract. In some cases, mass spirometry of the population is carried out to determine the health status of residents of certain geographical or environmental zones.

Indications for analysis

Test indicators for bronchial asthma

Bronchial asthma- refers to chronic diseases, a sign of which is an attack of suffocation resulting from swelling of the bronchial mucosa and spasm of smooth muscles.

non-infectious allergens (substances that cause allergic reactions):
. pollen
. medications
. insect bites
. food products, etc.

infectious allergens:
. viruses
. bacteria
. mushrooms

chemical substances:
. alkalis
. acids

physical factors:
. air temperature changes
. changes in atmospheric pressure
. stress influences

Hereditary genetic predisposition, certain working and living conditions, and previous viral respiratory and allergic diseases can also predispose to the development of bronchial asthma.

The main manifestation of bronchial asthma is an attack of suffocation (usually at night), which lasts from several minutes to several days.
The inhalation becomes short and the exhalation becomes longer.
Worried about cough, shortness of breath. During the period of suffocation, there is a cough with difficult to separate viscous sputum, the amount of sputum at the end of the attack increases, and it comes off more easily (“vitreous sputum”).

Airway inflammation and obstruction in asthma

Laboratory research indicators

General blood analysis. One of the signs of the disease is eosinophilia, which is more pronounced with frequent attacks; in some cases, eosinophilia may be observed immediately before an attack, and after an attack and in remission, eosinophilia may be absent.
Elevated levels of hemoglobin and red blood cells appear with the development of external respiration failure. ESR is moderately increased.

Research in bronchial asthma. Pulmonary function test (PRF)

For diagnosis of bronchial asthma. For dynamic monitoring of patients and assessment of the effectiveness of therapy, exhalation flow rates are recorded. Such tests are especially useful when the patient has no symptoms of asthma or signs of difficulty breathing.

Airflow speed and lung volume is recorded using spirometry during forced expiration. Limitation of air flow rate in bronchial asthma causes smaller partial lung expiratory volumes. Spirometric normative values ​​for OOB1 have been developed for children of different heights, genders, and ethnicities. The decrease in FEV1, expressed as a percentage of the standard value, is one of four criteria for the severity of bronchial asthma.

Since sick the lungs are usually inflated, often very much, the ratio of FEV1 to FVC allows one to calculate their total expiratory volume. An FEV1/FVC ratio of less than 0.8 usually indicates significant airflow limitation. However, it is impossible to diagnose bronchial asthma solely on the basis of a decrease in air flow velocity, since this is also typical for many other pathological conditions. With bronchial asthma, inhalation of beta-agonists (for example, salbutamol through a nebulizer) dilates the bronchi more strongly than in the absence of asthma; Asthma is characterized by an increase in FEV1 by more than 12%.

It's important to remember that diagnostic value of spirometric data depends on the patient’s ability to perform repeated full and forced exhalations. Children over 6 years of age usually perform this procedure easily. Spirometric data are only meaningful if they are reproducible over the course of the study. If, after three consecutive attempts, FEV1 differs by no more than 5%, then they focus on the best of the three indicators.

Solopov V.N. Asthma. Evolution of the disease

Pulmonary function test

A. Breathing disorders in bronchial asthma are caused by reversible airway obstruction, which is manifested primarily by a decrease in FEV 1 and peak volumetric flow rate. These values ​​usually return to normal quickly after the use of bronchodilators (see Fig. 7.3). An increase in FEV 1 after the use of bronchodilators by more than 20% indicates reversible bronchospasm. When the bronchi are blocked by mucus plugs and swelling of the mucous membrane, the effect of bronchodilators is slower. It should be remembered that the absence of a significant increase in FEV 1 after the use of bronchodilators does not exclude the diagnosis of bronchial asthma. The lack of response may be due to the following reasons: 1) absence of obstruction or slight obstruction of the airways during the interictal period, 2) the effect of bronchodilators used shortly before the study, 3) improper use of inhaled bronchodilators, 4) bronchospasm caused by irritating substances included in the composition inhaled bronchodilators, 5) bronchospasm caused by diagnostic procedures, in particular spirometry.

1) During the interictal period, FEV 1 is usually normal. Indicators of FEV 1 and peak volumetric flow rate reflect the condition of large bronchi. With narrowing of small (less than 2-3 mm in diameter) bronchi, FEV 1 and peak volumetric velocity are often normal (FEV 1 is reduced only with severe obstruction of small bronchi). To assess the condition of the small bronchi, another indicator is used - the average volumetric flow rate of mid-expiration. To determine it, a graph of the dependence of air flow on the volume of forced exhalation is plotted - the flow-volume curve (see Fig. 7.3). It should be remembered that an isolated decrease in the average mid-expiratory volumetric flow rate can also be observed in the interictal period.