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1. Lung function testing is important in the diagnosis, severity assessment and monitoring of lung diseases.
2. Spirometry measures forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio. Its uses include: screening for airflow limitation, assessing disease progression and diagnostic purposes (in combination with further lung function testing).
3. Lung volume measurements provide additional information to help differentiate restrictive, obstructive and mixed lung diseases.
4. Transfer factor for carbon monoxide (TLCO) (diffusion capacity of carbon monoxide (DLCO)) measures the ability of the lungs to transfer inhaled gas from the alveoli to red blood cells in the pulmonary capillaries. It can be used alongside the carbon monoxide transfer coefficient (KCO) for diagnostic purposes and to monitor disease progression.
5. Lung function testing is subject to a number of limitations and, as such, should be interpreted with flow–volume loops and clinical context.
By
Harald Herkner, Editor Cochrane Anaesthesia Review Group, Specialist Internal Medicine, Intensive Care Medicine, Cochrane Anaesthesia Group; Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria,
Christof Havel, Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
This chapter discusses respiratory support including indication and conditions requiring respiratory support. Respiratory support strategies vary to a great extent between the extreme obstructive lung disease (OLD) and acute respiratory distress syndrome (ARDS). The chapter gives a short overview of the principals of antimicrobial therapy. It also concentrates on the two indications, which are common in intensive care medicine: cardiac arrest and septic shock. In severe sepsis, coagulation abnormalities often develop following endothelial damage or organ dysfunction. Current intensive care medicine includes some key interventions which are merely related to the therapy of severe sepsis and septic shock, although the spectrum of intensive care is rather wide. Research in intensive care is hampered by heterogeneity and relatively low patient numbers in particular departments, which requires usually more complicated multi-centre studies.
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