In PFT, what does fair lung volume mean?

Question

Hi doctor,

Here are the details of my chest issues that I was hoping you could help me with. I will attach all the information I have in terms of X-rays and function tests. I am 37 year old otherwise healthy female with a normal BMI. I have a smoking history of 16 packs a year. Four years ago, I quit smoking completely. Now, I regularly run for around 1 or 2 miles.

My symptoms include mild dyspnea with a feeling that cannot get a satisfying breath. Tender feeling in the lungs on deep outward or inward breath or cough. The tender feeling in the upper back under the shoulder blade. I have a feeling of a chest infection or inflammation, but there is no mucus production and no spontaneous coughing. I have chest tightness. I have good and bad days, but generally, the symptoms remain constant. I do not get anxious, except about this. My oxygen saturation showing normal at rest and my EKG is normal. I have attached chest x-rays of the last five years as well as current bloodwork and spirometry. The first basic pulmonary function included a post-bronchodilator test and was done at clinic A (general clinic). The second PFT included lung functions and diffusion capacity and was carried out at clinic B (pulmonology clinic).

I was prescribed Albuterol and started taking it 1.5 weeks ago. I have an initial appointment with a pulmonologist in a week. Basically, I am trying to get an opinion for the following. What is going on? Will things get worse from here? Is there hyperinflation of my lungs for the last 6 years or is this a new finding? What are the values in the second PFT indicating fair lung volume and fair diffusion capacity? What does the isolated DLCO/VA value mean? Is this reversible? Please explain.

Answer 1

Hi,

Welcome to icliniq.com.

Your initial x-ray itself was showing some signs of hyperinflation and the subsequent x-rays shows increased hyperinflation. So, it is not a new finding, but worsening of the initial finding (attachment removed to protect patient identity). Unless some intervention is done, things may worsen for you. Fair lung volume means the lung volumes are normal. But, in the presence of hyperinflation it has to be interpreted carefully as hyperinflation increases the lung volume, but that does not mean that lung condition is improving. Diffusion capacity means the ability of the lungs to transfer oxygen or other gases from lungs to blood and vice versa. If it is fair, then it means the gas exchange across the lungs is happening fine. DLCO (diffusing capacity for carbon monoxide) is the measure of diffusion capacity and VA is the measure of alveolar volume, In your case, alveolar volume is increased due to hyperinflation and hence, DLCO/VA value is low. With daily breathing exercise this can be improved.

Answer 2

Hi,

Welcome back to icliniq.com.

Yes, this is emphysema. In this condition there will be air trapping. It means the amount of air you breath in cannot be breathed out and some of it gets trapped in the lungs. With continuing air trapping, your ability to take more air into the lungs gets restricted and that is the reason why you get pain upon deep breathing. As of now your condition is very mild to be started on any kind of medications. The things which you need to do is as follows.

Avoid exposure to all kinds of smoke, dust and cold air.
Do daily deep breathing exercise. It would be better if you could learn it from some Yoga teacher.
Get a tool called spirometer and use it every day. This is a simple tool used for breathing exercise.
Get vaccinated for Flu and Pneumococcal infections and get pulmonary function test done once yearly.

In PFT, what does fair lung volume mean?

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