Measuring Breathlessness With A Spirometer

By Serena Price


Difficulty breathing is a common complaint and a conundrum for the diagnostician. A spirometer is a type of pulmonary function monitor PFM), a device that measures the volume of air breathed in and out by the lungs. The printed output from the device will detect two different kinds of atypical ventilation patterns, restrictive and obstructive. There are several types of spirometers that use different approaches for measuring air movement (ultrasound, water gauge, pressure transducers). Today, there are also standalone and computer-based devices.

Pulmonary function tests are used to rule out lung diseases such as emphysema, bronchitis and asthma. They are also used to determine the cause of shortness of breath, assess the effects of medications or contaminants on the lungs and to monitor the progress of treatment. They are performed in advance of lung surgery as a benchmark with which to compare the effectiveness of the procedure.

It was Claudius Galen, noted Roman physician, who devised the first PFM and conducted the first lung function tests. This took place in the late first or early second century AD. Later instruments were based on a bell jar turned upside down in water. Modern variants include the whole body plethysmograph, peak flow meter and the pneumotachometer.

The vast majority of lung conditions are not serious and are easily treatable. It is important first to rule out a serious condition underlying the breathlessness. According to the Mayo Clinic in Arizona, Florida and Minnesota, shortness of breath is defined as an intense feeling of chest tightness accompanied by a feeling of suffocation. This can occur in a single instance or it may have a more chronic pattern.

There are a handful of "red flag" signs which, when they occur at the same time as breathlessness, may indicate a serious underlying condition. These include persistent tiredness and pallor, a chronic wheeze or cough, ankle swelling, a pain that gets worse with exercise, breathlessness that worsens when lying down, any other unusual or recurring symptoms. A history of working with hazardous chemical fumes, asbestos, wood dust or in a coal mine is also something worth mentioning to the doctor.

Asthma, a chronic inflammation of the airways, is one of these serious conditions. The Centers for Disease Control in Atlanta estimate that, at any one time, there are as many as 18.9 million ambulatory adults with asthma. This equates to 8.2 percent of those adults who are not institutionalized.

Once serious causes of breathlessness have been eliminated from the differential diagnosis, many cases can be traced to one of two simple and easily remedied causes, either trigger points, also known as muscle knots, or dysfunctional respiratory habits and weak muscles. The treatment for both is safe, cost-free and easily performed by the patient. It involves a program of exercise and trigger point massage.

A spirometer is an instrument that has been in use for two millennia to detect the cause of breathlessness. It can determine whether it is present and identify whether it is restrictive or obstructive but requires further investigations to rule out the presence of any serious conditions, such as emphysema, asthma or bronchitis. Once these have been eliminated from consideration, they may be attributable to either trigger points or incorrect breathing patterns.




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