International Journal of Engineering Trends and Technology (IJETT) - Volume4Issue5- May 2013

Diagnostic Spirometer
Reeva Prakash Chauhan
BTech, ME Government Engineering college Biomedical Department Sector 28 Gandhinagar, Gujarat

Abstract: The Respiratory cycle include inhale and Exhale lung volumes. From the lung volume the capacity of lung will be defined. As per ATS (American Thoracic Society) lung disease increased rapidly in the world. The detecting of COPD, Asthma like is possible only by spirogram. To measure respiratory capacity spirometer is good technique. Using spirometer early detection of lung diseases is possible. The present paper includes the methods for diagnoses of lung diseases. This paper describes the perfect technique to get precise result of respiratory capacity. The hardware includes differential pressure and data acquisition board. To get live patient data fuzzy system is acquired. Using some ATS standards, deviations and algorithm lung functions are diagnosed. Fuzzy system is developed in the Lab view software. This software includes comparative data of lung parameter and gives diagnosis as per standards. Keywords: Spirometer, Fuzzy Tool, Algorithm, standard equation Introduction Spirometry is recommended for the diagnosis and management of asthma and COPD in national and international guidelines, and specialist respiratory groups such as the American Thoracic and European Respiratory Societies (ATS/ERS). Improved recognition and care of patients with chronic obstructive pulmonary disease (COPD) is underpinned by a need for high quality, reliable, diagnostic spirometry. For diagnosis of COPD and Asthma mainly FVC (Forced Vital capacity) , FEV1 (Forced Expiratory Volume in 1 second) , and ratio of both the parameter. Spirometry measures ventilation, the movement of air into and out of the lungs. The spirogram will identify two different types of abnormal ventilation patterns, obstructive and restrictive. These parameters are measured from flow volume loop and flow rate / time graph. Theses curves are getting into PC with lab view software. In Lab view soft ware using fuzzy tool the algorithm for spirometer were developed. Standardization of equation and ratio of FVC/FEV1 is used to develop the algorithm. To get the precise data of patient some consideration should be taken. Lung Capacity measurement parameter:

FVC: FVC is the volume change of the lung between a full inspiration to total lung capacity and a maximal expiration to residual volume. FEV1: Volume that has been exhaled at the end of the first second of forced expiration. VC: This is the amount of air (in liters) moved out of the lung during normal breathing. The patient is instructed to breathe in and out normally to attain full expiration. TLC: Total lung capacity is full capacity of lung for exhaled and inhaled air. Above describe parameters and many more parameter are displayed in Spirogram and floe volume curve. Technique How to do the spirometry test. To ensure an acceptable result, the FVC man oeuvre must be performed with maximum effort immediately following a maximum inspiration; it should have a rapid start and the spirogram and flow-volume curve should be a smooth continuous curve. To achieve good results, carefully explain the procedure to the patient, ensuring that he/she is sitting erect with feet firmly on the floor (the most comfortable position, though standing gives a similar result in adults, but in children the vital capacity is often greater in the standing position). Apply a nose clip to the patient's nose (this is recommended but not essential) and urge the patient to: Breathe in fully (must be absolutely full) Seal his/her lips around the mouthpiece Immediately blast air out as fast and as far as possible until the lungs are completely empty Breathe in again as forcibly and fully as possible (if inspiratory curve is required and the spirometer is able to measure inspiration). If only peak expiratory flow is being measured then the patient need only exhale for a couple of seconds. Essentials are: To breathe in fully (must be absolutely full) A good seal on the mouthpiece Very vigorous effort right from the start of the maneuver and continuing until absolutely no more air can be exhaled No leaning forward during the test obtain at least 3 acceptable tests that meet repeatability criteria

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International Journal of Engineering Trends and Technology (IJETT) - Volume4Issue5- May 2013 Reference figure 1 Technique for PFT test. obstructed lung (below), how FVC is smaller than normal, but also that FEV1 is much smaller than normal. This is because it is very difficult for a person with an obstructive disease (e.g. asthma) to exhale quickly due to the increase in airway resistance. As a result, the FEV1/FVC ratio will be much lower than normal, for example 40% as opposed to 80%. The time taken for total volume expulsion generally does not exceed 3 s. The volume expelled during first 1 second (FEV1) and the total air expelled (FEV) are calculated. From that information, the ratio of FEV1/ FEV is obtained. This ratio is very important for diagnosis. The relationship between the flow and volume provides useful information about pulmonary function. Fuzzy rules: Table 1 Severity of obstruction FEV1 Mild Moderate Severe Very severe Positioning of the patient: Getting the patient comfortable and in the proper position is important step. Have the patient loosen any tight clothing, such as neckties, belts. Denture should be left in place unless they are loose and interfere with performance of test. Measurements curves: Figure 2 Table 2 Severity of restriction FVC Mild Moderate Severe % of predicted >65 to 80 >50 to 65 <50 % of predicted >80 50 to 79 30 to <30

Table 1 and table 2 describe the rules for obstructive and restrictive disease. The value of FVC and FEV1 is decided from the flow rate /second graph. The % of FVC and FEV1 is mark up on the graph. Decrement and increment/normal % of FVC and FEV1 graph divide in 25% to 75%. Figure 3 Figure 4 FVC report Liter

25% 50% (Reference figure) 75% The figure 2 and figure 3 describes the volume/ time (flow rate) curve. From the flow rate curve % of the FVC and FEV1 can be measured. The FVC test allows one to clearly distinguish between the two disease types. Notice in the

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International Journal of Engineering Trends and Technology (IJETT) - Volume4Issue5- May 2013 Figure 4 shows the flow rate graph of spirometer. The marks on the graph define the % of FVC. For diagnosis of diseases algorithm is prepared in fuzzy tool. Figure 5 diagnosis algorithm for spirometer.
6) 7) Streeter, Victor,. Mecnica de los Fluidos. Mxico: Mc Graw Hill et al 1975 Nydia Ivette Domnguez Martnez. Digital Spirometer construction with lab view interface Tesis de licenciatura, UDLA, 2007 Jones & bretllet learning LLC. Forced spirometry and Relted Tests ,Ch1 Int. J. Biomedical Engineering and Technology, Vol. x, No. x, 200x Rolf M. Schlegelmilch, Rdiger Kramme part B 8.1sec R. B. Darling EE-436 Laboratory 3 pdf. Measurement of respiratory system Rank P. Primiano, Jr.ch 9 David P Johns, Corrie M Ingram, Souvanny Khov, Peter D Rochford, E Haydn Walters Effect of breathing circuit resistance on the measurement of ventilatory function Thorax 1998;53:944948 J. Wanger, J.L. Clausen, A. Coates, O.F. Pedersen, V. Brusasco, F. Burgos, R. Casaburi, R. Crapo, P. Enright, C.P.M. van der Grinten, P. Gustafsson, J. Hankinson, R. Jensen, D. Johnson, N. MacIntyre, R. McKay, M.R. Miller, D. Navajas, R. Pellegrino and G. Viegi Standardization of the measurement of lung volumes European Journal of Respiratory Volume 26 number 3 Anthony D. DUrzo ,Itamar Tamari ,Jacques Bouchard Reuven Jhirad , Pieter Jugovic Limitations of a spirometry interpretation algorithm The Lung Association; 2007 Shubhajit Roy Chowdhury1, Dipankar Chakrabarti2, Hiranmay Saha3, Development of an FPGA Based Smart Diagnostic System For Spirometrics Data Processing Application International journal on smart sensing and intelligent systems, vol. 1, no. 4, december 2008 Agnaldo Jose Lopes,I Domenico Capone,I Roberto Mogami,II Regina Serrao Lanzillotti,III Pedro Lopes de Melo,IV Jose Manoel JansenV Severity classification for idiopathic pulmonary fibrosis by using fuzzy logic CLINICS 2011;66(6):1015-1019 Clare Hawkins, Isaac M. Goldberg COPD: Spirometry

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The algorithm prepared in fuzzy tool. For making the system easy and reliable lab view is good option. In lab view we can prepared the soft ware system which can take data from the hardware. In the lab view fuzzy system designer was used for making the rules for spirometer. Different methods are used for diagnosis of lung diseases. Nitrogen wash out, Helium dilution, DLCO etc. for different methods more standards were described by researcher. Here we define method using flow graph of spirometer. From the severity of obstruction and restriction the lung diseases are measured. The soft ware method for diagnosis gives more precise and easy to use. Also patient feels comfort while give test. Figure 6 block diagram of spirometer in Fuzzy system designer

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AUTHOR: Reeva Prakash Chauhan received B.TECH degree in Bio Medical Engineering from U V Patel College of Engineering, Ganpat University Mehsana, in 2008. After completion during 2008 to 2011 worked as an Assistant Manager of Operation Theatre in Shalby Hospitals, Ahmedabad, Gujarat. From March 2011 joined the Maharani Medicare Pvt. Ltd as a project biomedical Engineer. Research work carried out on US probe revision HIP surgery. Right now continue in ME in Bio medical Engineering from Government College of Engineering Gandhinagar Sec 28, Gujarat. Now as part of research study working on Digital Spirometer.

REFERNCES: 1) Madison low cost spirometers BME 301 University of Wisconsin - May 8, 2009 2) Egyptian Journal of Bronchology , December, 2009 Volume 3, No 2 3) Rolf M. Schlegelmilch, Ruddier Kramme Pulmonary Function Testing ch.8 page 77-117. 4) Basano L. y Ottonello P Ventilation Measurement. Measurement, Instrumentation, and Sensors Handbook. EUA:CRC 1999 5) European Respiratory Society: Standardized lung function testing. J. 6(Suppl 16), 352 (1993)

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