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A female patient presents with breathing difficulties. A pulmonary function test is ordered. She has a VC of 2,900 ml (normal is 4600ml), a TV of 450ml (normal 500ml), an IRV of 1850ml (normal is 1900ml) and an ERV of 600 ml (normal is 700ml). She has a forced expiratory volume in 1 second of 1800 ml (normal is 3000ml). Determine if this patient has obstructive or a restrictive pulmonary disorder?

Given a rate of 15 what are her minute ventilation (total pulmonary ventilation) and alveolar ventilation values (assume a dead space of 150 ml)

Answer :

The patient has a restrictive pulmonary disorder as per the values of pulmonary function tests. Restrictive lung disorders lead to a reduction in the total volume of air taken into the lungs.

This makes breathing harder for the individual as they are not able to breathe in enough air that their body requires. In addition, a decrease in the forced expiratory volume in 1 second indicates that the air is leaving the lungs at a slower rate than normal. This could be because the airway is narrowing, thus increasing the resistance to breathing.

To determine the minute ventilation, the formula is used:

Minute ventilation = tidal volume x respiratory rate Minute ventilation = 450 ml x 15 breaths per minute Minute ventilation = 6,750 ml per minute

To determine alveolar ventilation, the formula is used:

Alveolar ventilation = (tidal volume - dead space) x respiratory rate Alveolar ventilation = (450 ml - 150 ml) x 15 breaths per minute Alveolar ventilation = 4500 ml per minute

The dead space is subtracted because air in the dead space does not reach the alveoli. The total volume of air taken in by the lungs per minute is called minute ventilation. A certain amount of air is lost in the conducting zone that is called dead space. Hence, in the formula of alveolar ventilation, the dead space value is subtracted from the tidal volume.

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