HypAir PFS pulmonary function testing system

Beside spirometry measurement, several options can be added in the HypAir to have a full pulmonary function testing equipment which will fit exactly the needs of your lab.

Lung diffusion capacity:

The HypAir offers the largest choice of lung diffusion capacity measurement (DLCO) with 7 possibilities:

• Traditional Single breath DLCO with Helium tracer gas, with Sample collection bag
• DLCO by Single breath with real time gas analysis using rapid Helium and Carbon monoxide analysers
• DLCO  by single breath with real time gas analysis using a mulit gas infra red analyser for Methane and Carbon monoxide.
• DLCO Intra-breath, 2 second breath holding with constant exhalation method using either Methane of Helium trace gas
• Dm & Vc by Double Diffusion (DLco-DLno) obtained in a single breath diffuson test with Helium trace gas and Nitric oxide
• DLCO Re-breathing method, CO-He gases re-breathing for 10 seconds at approximately FEV1 volume.
• DLCO Steady State with Ventilation, CO inspired, CO expired, End tidal CO measurement, a tidal breathing method using low concentrations of Carbon monoxide

For single breath and intra-breath technique, you can choose the method to inhale the mixture:

• the fastest and most economical: through a demand valve.
• the most physiological, especially for patient with less cooperation: through an inhalation bag.

Lung volumes and sub-divisions measurement:

Either of two techniques to measure lung volumes can be chosen:

• FRC-He: lung volumes measurement by Helium dilution in a closed circuit, a rebreathing bag with CO₂ removal, the initial volume constant by O₂ compensation..
• FRC-N₂: Multiple breath Nitrogen washout (MBNW) method with demand valve or inspiratory bag delivery system, Lung Clearance index (LCI) measured from cumulative volume. ALSO;
• N₂ slope: Single Breath Nitrogen washout (SBNW)  to measure Fowler Dead space (Phase I, II), Alveolar plateau (Phase III) and Closing volumes and closing capacity (Phase IV).

Bronchoprovocation and Special Resistance Testing:

• Provo 4 Provocation System: with pressure triggered dosimeter firing only during inspiratory breath automated delivery calculation and number of breaths to achieve the dose, software controlled, accurate with minimised risk of excess aerosol entering the laboratory environment.
• RINT: Resistance by Interrupted airway, this tidal breathing method is ideal for children needing minimal co-operation.
• NEP (negative expiratory pressure): by use of a venturi to create a negative pulse on top of the tidal breathing loop to evaluate if airflow limitation can be overcome and quantified against a maximal effort.

Respiratory Mechanics Testing:

• MIP – MEP (maximum inspiratory and maximum expiratory pressure): indicator of respiratory muscle strength.
• SNIP: maximal nasal inspiratory pressure using a nasal cannula. A non-invasive indicator of diaphragmatic muscle fatigue.
• P0.1: inspiratory occlusion pressure at 0.1 seconds, for respiratory muscle drive evaluation.
• Static and dynamic compliance and resistance: measured by intra-esophageal balloon catheters.

The HypAir Muscle study is a comprehensive system to evaluate the respiratory muscles and neural drive responses.

The tests use the respiratory muscles chest wall and diaphragm using inspiratory and expiratory mouth pressures as peak and mean efforts. This can be expanded with Sniff pressures with the option of an abdominal belt to see diaphragmatic effort.

Trans diaphragmatic pressures can be measured by using a twin lumen catheter or two single lumen catheters positioned above and below the diaphragm to see the contribution to work of breathing.

The Neuro muscular response is measured using the inspiratory occlusion pressure developed

100 ms into inspiration, this test can be expanded with Carbon dioxide rebreathing to see the effect on the response, this is particularly valuable in COPD where there can already be significant CO₂ retention dulling the respiratory response to airway occlusions.

Phrenic nerve stimulation can be measured with additional Magnetic stimulation, this can also include EMG not supplied as part of the system, the EMG is place across the respiratory Chest muscles and the twin lumen or two discrete catheters are place above and below the diaphragm then the latency is measured between firing the magnetic pulse to stimulate the Phrenic nerve and the “twitch” response of the diaphragm and when EMG exist the respiratory muscle reaction.