Respiratory Function Testing
What is RFT?
RFT is a procedure that provides an objective and quantifiable evaluation of a patients respiratory capacity.
Why have you been prescribed RFT?
RFT is an essential test for any patient with suspected respiratory failure; it is significantly useful for the diagnosis of bronchial asthma and in forming a bronchopulmonary effect report after prolonged exposure to tobacco. It can also provide a means to detect pulmonary symptoms associated with certain systemic conditions such as scleroderma or to study the effects on the respiratory system caused by a wide range of pathologies (obesity, etc.).
RFT is completed systematically before any thoracic or upper abdominal surgery procedure, to identify any factors indicate the possibility of post-operative respiratory complications.
It is also a systematic screening procedure required by occupational physicians for professionals that are exposed to pathogens that affect the respiratory system.
RFT may be repeated to monitor the evolution of the condition and/or ensure that the treatment being used is effective.
Respiratory Function Testing procedure in detail.
The RFT procedure may vary in detail depending on the situation.
The basic tests are:
- spirometry (pulmonary volume, flow-volume graph);
- measurement of immobile volumes (by helium dilution).
Additional tests may be added in certain cases:
- bronchodilation test;
- arterial blood gas test;
- carbon dioxide transfer test;
Spirometry provides a measurement of usable volumes and air-flow. Nose clips are first applied to avoid leaks, you will then be asked to breathe into a mouth-piece that is linked to a measuring device. You will be asked to breathe normally or to follow specific instructions. Two different actions are completed. After breathing normally, on hearing the signal you will do one of the following:
– either exhale as much as possible to try to “completely empty” your lungs and then inhale deeply to fill them as much as possible,
– or inhale deeply and as much as possible, and then exhale emptying the lungs as quickly and as much as possible.
Each of these actions will be repeated at least three times.
The results will be recorded and processed by computer to produce graphs on its screen. The results will then be printed out.
What precautions are necessary before and after the test?
You should refrain from smoking for at least four hours before the test. You may also to stop your regular treatment for a period of time (8 to 18 hours depending on the type of inhaler).
Does RFT involve any discomfort?
For some people it may be unpleasant to experience the mouth-piece, nose-clips and have to breathe only through the mouth; one may find oneself salivating or feel nauseous, but the discomfort is relatively limited. The only uncomfortable test will probably be the blood-test.
What are the hygiene standards?
The mouth-piece, nose-clips and anti-bacterial filter are all disposable and single use, the rest of the equipment is sterilised. The doctor will wash their hands after each test.
Are there any contraindications?
These are rare and concern specific tests. Pulmonary embolism, pneumothorax, acute asthma attack and uncompensated COPD are contraindications.
Could there be any complications?
These are extremely rare.
Risk of pneumothorax (movement of the pleural cavity after an excess of pressure caused by exhaling violently through the mouth-piece) is exceptionally rare. An asthma attack when an asthmatic patient repeats the actions is also exceptionally rare. The communication of germs from one patient to another is avoided by the using only single use mouth-pieces and anti-bacterial and anti-viral filters between the apparatus and the mouth-piece.
What data is provided by RFT?
During the strenuous exhalation phase, the apparatus measures different volume and air-flow parameters which are then compared to theoretical standards. This evaluates the quality of your respiratory function. It may sometimes be necessary to use an inhaler to modify the respiratory function during the test and repeat the RFT 10 to 45 minutes later to assess the effect of the medication.
How long does the procedure take?
The time taken will depend on the number of individual tests completed (basic test only or additional tests), patient cooperation and if there is any tiredness associated with the test. The basic test usually takes 15 minutes or 30 minutes if an additional test is added.
When will you receive the results?
The doctor will give you a rough idea of the results at the end of the test.
Generally at least 24 hours will be required before you receive the final test report from the service reception. In certain cases (patients resident outside of the Paris region or unable to travel) the results can be sent by post to your home address or to your GP.
Where and by whom is Respiratory Function Testing carried out?
RFT takes place (using full body plethysmography) in the Functional Testing Unit by Doctor Fatima Maria ALMEIDA, qualified pneumology specialist. Ex-Paris Hospital Intern, ex-Assistant Clinic Head (Thoracic Oncology Unit of the Foch Hospital, Thoracic Oncology Unit of the Saint Louis Hospital, Pneumology Service of the HEGP), Doctor ALMEIDA was also part-time Hospital Physician at the Robert Ballanger Hospital, Aulnay-sous-Bois until April 2017.