Clinical Case Study: Clinical Case Study: Akron City HospitalAkron City Hospital

By: Kristen Scalf

History 43 year old Indian Male Diagnosed with

Sarcoidosis Non Smoker

SARCOIDOSISSARCOIDOSIS

• Sarcoidosis is characterized by the formation of tiny lumps of cells in various organs in your body. Symptoms include shortness of breath and cough.

PFT TESTS:PFT TESTS: First PFT completed in October

23rd, 2008

Ordered by Dr. N. Botros MD

This was a complete PFT without a bronchodilator

Spriometry/FVL/MVVSpriometry/FVL/MVVPredicted Pre

ReportedPre %

Reported

FVC (L) 5.37 4.77 89%

FEV1 (L) 4.02 3.94 98

FEV1/FVC (%) 74.78 82.71 111

FEV3 (L) 5.21 4.54 87

FEV3/FVC (%) 97.00 95.27 98

FEF25-75% (L/s) 4.01 4.15 103

FEF50% (L/s) 5.82 5.46 94

FIF50% (L/s) 5.41

FEF50/FIF50 (%) 100.98

PEFmax (L/s) 9.58 13.76 144>

TET (sec) 6.63

FIVC (L) 4.52

EV (L) 0.17

MVV (L/min) 145.89 145.91 100

Gas Dilution Lung Gas Dilution Lung VolumesVolumes

Predicted Pre Reported

Pre % Predicted

TLC (L) 7.58 5.82 77<

VC (L) 5.37 4.33 81

RV (L) 2.21 1.49 67<

RV/TLC (%) 29.10 25.57 88

FRC N2 (L) 4.20 2.59 62<

ERV (L) 2.00 1.10 55<

IC(L) 3.37 3.23 96

N2 Time (min)

0.95

DiffusionDiffusionPredicted Pre

Reported

Pre % Predicted

Dsb

(ml/min/mmHg)

30.49 32.17 105

DsbHb

(ml/min/mmHg)

30.49 32.17 105

D/VAsb

(ml/min/mmHg)

4.02 4.82 120

VAsb (L) 7.58 6.67 88

IVC (L) 4.69

Hgb (g/dl) 14.60

BHT (sec) 11.64

PFT PFT InterpretationInterpretation

Quality of Study : Good Forced Expiration Spirometry:

This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.

Respiratory Flow Volume Loop: Normal

MVV: The maximum voluntary ventilation is normal

Lung Volumes: The lung volumes show a reduced total lung capacity indication a mild restrictive ventilatory defect.

Diffusion Capacity by Single Breath CO: Normal

Impression: Mild Restrictive Ventilatory Defect

PFT TEST #2PFT TEST #2 Next PFT test was completed

on April 6th, 2009.

Ordered by Dr. A Kim MD

This was a complete PFT without a bronchodilator

Spriometry/FVL/MVVSpriometry/FVL/MVVPredicted Pre Reported Pre %

Reported

FVC (L) 5.37 4.88 91%

FEV1 (L) 4.02 3.88 97

FEV1/FVC (%) 74.78 79.48 106

FEV3 (L) 5.21 4.42 85

FEV3/FVC (%) 97.00 90.70 94

FEF25-75% (L/s) 4.01 3.62 90

FEF50% (L/s) 5.82 5.23 90

FIF50% (L/s) 8.04

FEF50/FIF50 (%) 65.13

PEFmax (L/s) 9.58 14.77 154>

TET (sec) 9.40

FIVC (L) 4.46

EV (L) 0.13

MVV (L/min) 145.89 152.77 105

Gas Dilution Lung Gas Dilution Lung VolumesVolumes

Predicted Pre Reported

Pre % Predicted

TLC (L) 7.58 5.79 76<

VC (L) 5.37 4.62 86

RV (L) 2.21 1.17 53<

RV/TLC (%) 29.10 20.23 70<

FRC N2 (L) 4.20 2.01 48<

ERV (L) 2.00 0.84 42<

IC(L) 3.37 3.78 112

N2 Time (min)

1.11

DiffusionDiffusionPredicted Pre

Reported

Pre % Predicted

Dsb

(ml/min/mmHg)

30.49 29.92 98

DsbHb

(ml/min/mmHg)

30.49 29.92 95

D/VAsb

(ml/min/mmHg)

4.02 4.61 114

VAsb (L) 7.58 6.50 86

IVC (L) 4.64

Hgb (g/dl) 14.60

BHT (sec) 11.35

PFT PFT InterpretationInterpretation

Quality of Study : Good

Forced Expiration Spirometry: This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.

Respiratory Flow Volume Loop: Normal

MVV: The maximum voluntary ventilation is normal

Lung Volumes: The lung volumes show a reduced total lung capacity indication a mild restrictive ventilatory defect.

Diffusion Capacity by Single Breath CO: Normal

Impression: Mild Restrictive Ventilatory Defect

Final PFTFinal PFT

• Final PFT conducted on Oct 6, 2009

• Ordered by Dr. A. Kim MD

• This was a complete PFT with bronchodilator

Predicted Pre Reported

Pre %

Reported

Post Reported

Post % Predicted

% Change

FVC (L) 5.49 4.96 90 5.07 92 2

FEV1 (L) 4.08 4.03 99 4.26 104 6

FEV1/FVC (%) 74.20 81.25 110 89.93 113 3

FEV3 (L) 5.33 4.66 87 4.78 90 3

FEV3/FVC (%) 97.00 93.91 104 94.17 97 0

FEF25-75% (L/s) 4.01 4.17 93 5.26 131> 26

FEF50% (L/s) 5.86 5.45 6.45 110 18

FIF50% (L/s) 8.26 6.82 -17

FEF50/FIF50 (%) 66.02 94.55 46

PEFmax (L/s) 9.70 12.55 129> 13.35 138> 6

TET (sec) 7.41 8.22 11

FIVC (L) 4.45 4.76 2

EV (L) 0.15 0.19 28

MVV (L/min) 148.06 140.61 95

Spriometry/Spriometry/FVL/MVVFVL/MVV

Gas Dilution Lung VolumesGas Dilution Lung VolumesPredicted Pre

ReportedPre % Predicted

TLC (L) 7.78 6.32 81

VC (L) 5.49 4.81 87

RV (L) 2.29 1.51 66<

RV/TLC (%) 29.42 23.94 81

FRC N2 (L) 4.33 2.77 64<

ERV (L) 2.04 1.26 62<

IC(L) 3.45 3.54 103

N2 Time (min)

0.75

DiffusionDiffusionPredicted Pre

Reported

Pre % Predicted

Dsb

(ml/min/mmHg)

30.56 30.11 99

DsbHb

(ml/min/mmHg)

30.56 30.11 99

D/VAsb

(ml/min/mmHg)

3.93 4.85 123>

VAsb (L) 7.78 6.22 80<

IVC (L) 4.64

Hgb (g/dl) 14.60

BHT (sec) 11.07

PFT PFT InterpretationInterpretation

Quality of Study : Good

Forced Expiration Spirometry: This demonstrates a normal spirogram, no large airways obstructive ventilatory defect.

Respiratory Flow Volume Loop: Normal

Inhaled Bronchodilator Response: Response noted

MVV: The maximum voluntary ventilation is normal