PFT Lab QI

If your lab is interested in Quality Improvement for Spirometry, I would strongly encourage you to check out Spirometry360 from the University of Washington. This system provides a variety of tools, but importantly quality feedback for each operator/technician doing spirometry in your lab. Tests can be sent for review electronically (if you are using an nDD spirometer) or on paper, and you will get very nice reports about how many of your tests (for each technician) are meeting ATS criteria, and why some tests do not. This does provide work suitable for ABP MOC credit, if you are interested in that, but it's a great way to improve  the quality of your lab testing.

With some of you, I am exploring ways in which similar QI assessments might be created for other lung function tests (plethysmography, diffusion, infant testing, etc).

PFT Lab Survey

We had created a survey of pulmonary function labs approximately 1 year ago to ask about practices, equipment, equations, protocols, etc. If your lab did not previously complete this survey, please head on over to:  http://www.surveymonkey.com/s/Y7YCKYR to complete the survey! Thanks

Exercise Testing

We should have a spot for this, too. What do you do? Treadmill? Bike? What equipment do you use?

Spirometry.

Didn't mean to leave out our most commonly done test for discussion points!

LCI?

Anyone doing LCI measurements? With what equipment? In what populations?

Lung Volumes issues

This post for discussing lung volume measurement issues...

Diffusing Capacity/Transfer Factor issues...

This post for discussion DLCO (or TLCO) issues...

Z-scores

Anyone else using them in addition to or instead of %predicteds? I am working on an interpretation schema that utilizes cutpoints of Z-scores instead of %pred. I suppose neither is perfect...

Educational Resources

MedGraphics sponsors a very nice seminar for folks new or not-so-new to pulmonary function testing. Read more about it here: http://www.medgraph.com/education.html#seminar

Predicteds

Which do you use?

Our lab switched ~3 years ago to a composite set:
Spirometry: Eigen (3-5 yrs), Dockery/Wang (6,7 yrs), NHANESIII (8-80)
Lung Volumes/Diffusion: Rosenthal (6-18); Crapo (19+)
Resp Muscle Pressures: Wilson

Forced Deflation Spirometry

Forced Deflation spirometry has been done here in Pittsburgh for ~30 years. While there are some drawbacks (it requires intubation and either deep sedation or paralysis), it also allows for testing of ventilated patients where that is not feasible with the IPL. For the last 30 years, this has been accomplished with some ... umm.... older technology (recording oscilloscope, polaroid camera, ruler), but just recently we have modernized this to run with a digital signal processing system and laptop (thanks, Joe!). Here, it has been commonly used to test children undergoing VEPTR, but we have used it for other purposes (pre-transplant evaluations in the ICU), or for children going to the OR for some other purpose where obtaining lung function would be helpful.

Do others have any experience with it?

Infant Lung Function Testing with the IPL

We have had an IPL here in Pittsburgh for ~3 years. Please use this space to share questions and answers about testing with the IPL.