Student Protocol Respiratory Airflow & Volume Written by staff of ADInstruments and modified by Dr. G.R. Davis, 28 November 2010 at 3:20 pm The PowerLab pneumotachometer is shown in Figure 2. Figure 2. The PowerLab Pneumotachometer Figure 3. Lung Volumes and Capacities Terms with Which You Should Familiarize Yourself: Term Abbreviation/ Symbol Respiratory Rate RR Expired Minute Volume VE = RR x VT Lung Volumes Tidal Volume VT Inspiratory Reserve Volume IRV Expiratory Reserve Volume ERV Residual Volume RV (predicted) Lung Capacities Inspiratory Capacity IC = VT + IRV Expiratory Capacity EC = VT + ERV Vital Capacity VC = IRV + ERV + VT Functional Residual Capacity FRC = ERV + RV Total Lung Capacity TLC = VC + RV Pulmonary Function Tests Peak Inspiratory Flow PIF Peak Expiratory Flow PEF Forced Vital Capacity FVC Forced Expired Volume in One Second FEV1 %FVC Expired in One Second FEV1 / FVC x 100 Page 1 of 11 ©2008 Units Breaths/min (BPM) L/min L L L L L L L L L L/min L/min L L % Respiratory Airflow & Volume Student Protocol Required Equipment LabChart software with Spirometry Extension PowerLab Data Acquisition Unit Spirometer Pod Respiratory Flow Head (1000 L/min) with connection tubes Clean-bore Tubing & Tubing Adapter Disposable Filters Reusable Mouthpieces Nose Clips Tape measure or wall chart for measuring height Reading material Medical tape Sharpened pencil Procedure If you are suffering from a respiratory infection, do not volunteer for this experiment. Equipment Setup 1. Make sure the PowerLab is turned on and 2. The Spirometer Pod is connected to Input 1 on the front panel of the PowerLab (Figure 4). Turn on the PowerLab. Note: Since the Spirometer Pod is sensitive to temperature and tends to drift during warm-up, it is recommended the PowerLab (and therefore the Spirometer Pod) is turned on for at least five minutes before use. To prevent temperature drift, place the Spirometer Pod in a shelf or beside the PowerLab, away from the PowerLab power supply to avoid heating. Figure 4. Equipment Setup for PowerLab 26T 3. Connect the two plastic tubes from the Respiratory Flow Head to the short pipes on the back of the Spirometer Pod. Attach Clean-bore Tubing, a Filter, and a Mouthpiece to the Flow Head (Figure 4). Page 2 of 11 ©2008 Respiratory Airflow & Volume Student Protocol 4. Turn OFF and collapse Channels 3-8. 5. Make the following settings: Sampling rate: 100/s, View: 10:1 compression. Channel 1 should be “on” and Channel 2 should be “off.” Range for Channel 1 = 500 mV. Input setting = Spirometer Pod. In the Channels Settings under the Setup Menu, retitle Channel 1 to Flow and Channel 2 to Volume. Note: A clean Mouthpiece and Filter should be supplied for each volunteer. The Mouthpiece can be cleaned between uses by soaking it in boiling water or a suitable disinfectant. Exercise 1: Familiarize Yourself with the Equipment In this exercise, you will learn the principles of spirometry and how integration of the flow signal gives a volume. Calibrating the Spirometer Pod The Spirometer Pod must be calibrated before starting this exercise. The Flow Head must be left undisturbed on the table during the zeroing process. 1. Your computer should already have the LabChart program running but if it doesn’t, launch LabChart and open the settings file “Airflow and Volume Settings” which should be found within one of the LabChart folders. 2. Select Spirometer Pod from the Channel 1 Channel Function pop-up menu. Make sure the Range is 500 mV and set the Low Pass to 10 Hz; then select Zero. When the value remains at 0.0 mV, have the volunteer breathe out gently through the Flow Head, and observe the signal (Figure 5). If the signal shows a downward deflection (it is negative), you can return to the Chart View. If the signal deflects upward, you need to invert it. Click the Invert checkbox once. Figure 5. Spirometer Pod Dialog with Downward Deflection Using the Equipment 1. Have the volunteer put the Mouthpiece in their mouth and hold the Flow Head carefully with both hands. The two plastic tubes should be pointing upward. 2. Put the nose clip on the volunteer’s nose. This ensures that all air breathed passes through the Mouthpiece, Filter, and Flow Head (Figure 6). Page 3 of 11 ©2008 Respiratory Airflow & Volume Student Protocol 3. After the volunteer becomes accustomed to the apparatus and begins breathing normally, you are ready to begin. Figure 6. Proper Positioning of the Flow Head 4. Start recording. Have the volunteer perform a full expiration and then breathe normally. Record the volunteer’s tidal breathing for one minute. At the end of one minute, have the volunteer perform another full expiration. Observe the data being recorded in the “Flow” channel. Stop recording. The volunteer can stop breathing through the Flow Head and can remove the Nose Clip. Setting Up the Spirometry Extension The Spirometry Extension processes the raw voltage signal from the Spirometer Pod, applies a volume correction factor to improve accuracy, and displays calibrated Flow (L/s) and Volume (L) traces. It takes over from Units Conversion. The trace you recorded in this exercise will provide reference points for the Spirometry Extension that allow it to calculated and perform corrections on the trace. 1. Drag across the Time axis at the bottom of the Chart View to select the data you recorded. Select Spirometry Flow from the Channel 1 Channel Function pop-up menu. Make sure the settings are the same as those in Figure 7. Note: your screen may not appear exactly as Figure 7 due to updates in the software that are provided from time to time. In any case, no changes are likely needed. Figure 7. Spirometry Flow Dialog Page 4 of 11 ©2008 Respiratory Airflow & Volume Student Protocol 2. Select Spirometry Volume from the Channel 2 Channel Function pop-up menu. Make sure Channel 1 is selected in the Spirometry Flow Data pop-up menu. Click the Apply Volume Correction checkbox to turn it on. Then select Apply to allow the extension to use the volume correction ratio that is has calculated from your data (Figure 8; again your computer screen may not be exactly like Figure 8). The Chart View should now appear with calculated volume data on Channel 2. Figure 8. Spirometry Volume Dialog 3. Select Set Scale from the Scale pop-up menu in the Amplitude axis for the “Flow” channel. Make the top value 15 L/s and the bottom value -15 L/s. 4. Save your data to the desktop using your last name and lab section as the file name. Do not close the file. Exercise 2: Lung Volumes and Capacities and Pulmonary Function Test In this exercise, you will examine the respiratory cycle and measure changes in flow and volume. 1. Zero the Spirometer Pod again, using the same procedure as before (Spirometer pod under Channel 1 and then Zero). Remember to leave the Flow Head undisturbed during the process. Volunteers are not breathing in the apparatus for the zeroing procedure. 2. Have the volunteer face away from the monitor and read while breathing through the spirometer without the nose clip. Reading will distract the volunteer and prevent the volunteer from consciously controlling their breathing during the exercise. 3. When ready, Start recording. After two seconds, have the volunteer replace the Nose Clip and breathe normally into the Flow Head. Record normal tidal breathing for one minute. 4. After the tidal breathing period (at the end of a normal tidal expiration), ask the volunteer to inhale as deeply as possible and then exhale as deeply and as quickly as possible. Afterwards, allow the volunteer to return to normal tidal breathing for at least 7 breaths. 5. After about 7 normal breaths, ask the volunteer to inhale as deeply as possible and then exhale as deeply and quickly as possible. You have now recorded data that will allow you to measure and calculate lung volumes and capacities. 6. Stop the recording. Page 5 of 11 ©2008 Respiratory Airflow & Volume Student Protocol 7. Click Autoscale from the popup menu in the Volume axis amplitude scale. 8. Save your data. Do not close the file. 9. The volunteer can remove the nose clip and discontinue breathing through the flow head. Based on the large breaths your volunteer made, you will measure parameters of forced expiration that are used in evaluating pulmonary function. Note that the Spirometry Extension is not intended for clinical evaluation of lung function but can be used as an approximation for teaching purposes. Figure 9. Sample Data of Forced Breaths Exercise 3: Simulating Airway Restrictions (Time Permitting at the end of lab according to instructor’s decision.) In this exercise, you will demonstrate the effects of bronchial restrictions, such as asthma, by making modifications to your equipment. 1. Cover the mouth-end of the Mouthpiece with medical tape. Use a sharpened pencil to make a hole in the tape one centimeter in diameter. Place the Mouthpiece on the Filter, as in Figure 4. 2. Attempt the pulmonary function tests with the restricted airway. Repeat the entire procedure from Exercise 3, including recording from each student in the group if time allows. Page 6 of 11 ©2008 Respiratory Airflow & Volume Student Protocol Analysis Lung Volumes and Capacities 1. Examine the normal tidal breathing data in the Chart View, and Autoscale, if necessary. Calculate how many breaths there are in a one-minute period (BPM). Record RR/min in Table 1 of the Data Notebook. 2. Determine the volume of a single tidal inspiration by placing the Marker at the start of a normal tidal inspiration. Place the Waveform Cursor at the peak (Figure 10). The value shown in the Range/Amplitude display for Channel 2 is the tidal volume (V T) for that breath. Record this value in Table 1 of the Data Notebook. Figure 10. Proper Placement of Marker and Waveform Cursor 3. Use the values for tidal volume and the number of breaths observed over a one minute period to calculate the expired minute volume (VE). Use the following equation: VE = RR x VT (L/min) 4. Use the marker and cursor to determine the inspiratory reserve volume (IRV) (Figure 11) and expiratory reserve volume (ERV) (Figure 12). Note: The Marker should be placed at the peak of a normal tidal inspiration for IRV, and it should be placed at the start of a normal tidal inspiration (trough) for ERV. 5. Calculate the inspiratory capacity (IC) using the following equation: IC = VT + IRV Page 7 of 11 (L) ©2008 Respiratory Airflow & Volume Student Protocol 6. Calculate the expiratory capacity (EC) using the following equation: EC = VT + ERV (L) Figure 11. Positioning of Marker and Waveform Cursor to Measure IRV Figure 12. Positioning of Marker and Waveform Cursor to Measure ERV Page 8 of 11 ©2008 Respiratory Airflow & Volume Student Protocol 7. Refer to the Appendix in the Student Protocol, and use the tables provided to determine the volunteer’s predicted vital capacity (VC). The predicted value varies according to the volunteer’s sex, height, and age. 8. Calculate the volunteer’s measured VC using the experimentally derived values for IRV, ERV, and V T. Use the following equation: VC = IRV + ERV + VT (L) 9. Residual volume (RV) is the volume of gas remaining in the lungs after a maximal expiration. The RV cannot be determined by spirometric recording. Using the following equation, determine the predicted RV value for the volunteer: RV = predicted VC x 0.25 (L) 10. The total lung capacity (TLC) is the sum of the vital capacity and residual volume. Calculate the predicted TLC for the volunteer using the following equation: TLC = VC + RV (L) 11. Functional residual capacity (FRC) is the volume of gas remaining in the lungs at the end of a normal tidal expiration. Use the following equation: FRC = ERV + RV (L) 12. Select an area of the Chart View that contains normal breathing, making sure to select across complete respiratory cycles in the time axis. Select Report from the Spirometry menu. The Spirometry Report window contains various parameters calculated by the Spirometry Extension from the data selection (Figure 13; again software updates may cause the screen to appear a little different.) Copy the results for VE, VT, and ƒ (which is RR) into the appropriate column in Table 1 of the Data Notebook. 13. Make sure you have entered all the values calculated into Table 1 of the Data Notebook. Page 9 of 11 ©2008 Respiratory Airflow & Volume Student Protocol Figure 13. Spirometry Report Pulmonary Function Tests 1. USE YOUR OWN DATA FOR THIS ANALYSIS. 2. To calculate the forced vital capacity (FVC), place the Marker on the peak inhalation of “Volume,” and move the Waveform Cursor to the maximal expiration (Figure 14). Read off the result from the Range/Amplitude display, disregarding the delta symbol and negative sign. 3. Return the Marker to its box. To measure forced expired volume in one second (FEV 1), place the Marker on the peak of the volume data trace, move the Waveform Cursor to a time 1.0 s from the peak, and read off the volume value. If you find it hard to adjust the mouse position with enough precision, a time value anywhere from 0.96 s to 1.04 s gives enough accuracy. Disregard the delta symbol and negative sign. Return the Marker to its box. Select data from the last recorded data block for this exercise that includes a couple of normal breaths, the forced breath, and a few more normal breaths (Figure 14). Select Report from the Spirometry menu. The Spirometry Report window opens. 4. Figure 14. Spirometry Data Window, with the Locations of the Parameters 5. Calculate the percentage ratio of FEV1 to FVC for your experimental and compare your values to those calculated in the Spirometry Report results. Use the maximum values of FEV1 and FVC, and use the following equation: (FEV1 / FVC) x 100 (%) 6. Record your values in Table 2 of the Data Notebook. Page 10 of 11 ©2008 Respiratory Airflow & Volume Student Protocol Appendix: Vital Capacities in Healthy Individuals1 Height (cm) Table 1. Predicted Vital Capacities for Males Height (cm) Table 2. Predicted Vital Capacities for Females Copyright © 2008 ADInstruments Pty Ltd. All rights reserved. PowerLab® and LabChart® are registered trademarks of ADInstruments Pty Ltd. The names of specific recording units, such as PowerLab 8/30, are trademarks of ADInstruments Pty Ltd. Chart and Scope (application programs) are trademarks of ADInstruments Pty Ltd. www.ADInstruments.com 1 These tables are based on The Johns Hopkins Pulmonary Function Laboratory equations for pulmonary function. http://www/hopkinsmedicine.org/pftlab/predeqns.html/ Page 11 of 11 ©2008