AOCOPM 2023 Midyear Educational Conference-259668

Video Transcription

Video Summary

The speaker discusses challenges in interpreting spirometry results for patients with anatomical differences or health conditions, particularly in the context of federal black lung evaluations. Cases include individuals who have had a lobectomy or pneumonectomy and patients with obesity, transgender individuals, stroke survivors, and those with Parkinson's disease. For lobectomies, research suggests a 15-20% decrease in FEV1 and FVC. For pneumonectomies, there's about a 41% decrease for right lung removal and a 34% decrease for left lung removal. The speaker emphasizes adjusting predicted values rather than actual measured results to make them defensible, particularly in legal situations. Obesity, up to a BMI of about 40, shows no significant impact on spirometry results, while obesity hypoventilation syndrome is distinct and correctable. For transgender individuals, spirometry should use sex assigned at birth unless hormone treatment began pre-puberty. Stroke impacts are too variable for a standard adjustment. Parkinson's disease affects spirometry predictably depending on disease severity, using the H and Y scale for adjustments. The speaker recommends considering these nuances to assess patients' respiratory functions accurately.

Keywords

spirometry

anatomical differences

black lung evaluations

lobectomy

pneumonectomy

obesity

transgender individuals

Parkinson's disease