ATS Pulmonary Function Laboratory Manual

ATS Pulmonary Function Laboratory Management & Procedure Manual | 3rd Edition

Table 10.1

3. 4. Infection control supplies: disposable in-line filters (if used), gloves, gowns, masks, and protective eye wear (if applicable). 5. Computer/printer supplies. Patient Preparation (Pre-Test Instructions) 1. The patient should refrain from smoking or other CO exposures on the day of the test. The time of the last cigarette smoked should be recorded and noted in interpretation. Because air pollution may also result in higher COHb, exposure to high levels of air pollution should be noted. A correction for CO back-pressure should be made for recent or heavy cigarette smoking. 2. Measure patient’s height in centimeters (cm) to nearest cm, or in inches (in) to nearest ½ in, while he/she is standing erect, without shoes. 3. The patient’s weight should be measured using an accurate scale: weight is not required for reference values for Dl CO , but may be useful for interpretive purposes. Some systems use weight to estimate the anatomic dead space. 4. The patient’s age should be recorded as age on day of test. 5. The Dl CO test should be done in the sitting position, with the patient sitting quietly for at least 5 minutes before testing and remaining seated throughout the procedure. 6. The patient should refrain from heavy exercise immediately before the test and refrain from having a large meal for at least 2 hours before the test. 7. Ingestion of ethanol has been reported to decrease Dl CO (18, 29). The mechanisms involved are not clear, although it is known that some fuel-cell CO analyzers are sensitive to exhaled ethanol and ketones. One sug- gestion is to have the patient refrain from drinking alcohol for at least 4 hours before testing. Indications for Dl CO include (8, 9) • Evaluation and monitoring of diseases which involve lung parenchyma (e.g., those associated with dusts, drug reactions, or sarcoidosis) • Evaluation and monitoring of emphysema • Differentiating among chronic bronchitis, emphysema, and asthma • Evaluation and monitoring of pulmonary involvement in systemic disease • Evaluation of cardiovascular diseases • Prediction of arterial desaturation during exercise in some patients with lung disease • Evaluation and quantification of impairment and disability associated with interstitial lung diseases and emphy- sema • Evaluation of the pulmonary effects of chemotherapy agents or other drugs known to induce pulmonary dysfunc- tion • Evaluation of pulmonary hemorrhage Mouthpiece, nose clip, carbon dioxide (CO 2 ) and water absorbers (if applicable), and other miscellaneous supplies needed (e.g., tissues).

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