Pocket guide to lung function tests:explanations without equations.
- M.C.F. Pain
- Aust Prescr 2006;29:70
- 1 June 2006
- DOI: 10.18773/austprescr.2006.043
Sydney: McGraw-Hill; 2006.
176 pages. Price $34.95
This little book first appeared in 2001 with a reprint in 2003. The appearance of a second edition shows that it has found a market. Although not specifically spelt out, it appears that the second edition has been 'revised throughout' with the addition of chapters 12 and 13 dealing with the preoperative assessment for thoracic surgery and fitness for flying. The basic approach in the interpretation of tests is of pattern recognition rather than requiring much knowledge of pure respiratory physiology and I have no quarrel with that. Most of us read an ECG without much knowledge of cardiac electrophysiology.
In nine chapters covering the commonly used tests, from spirometry to cardiopulmonary exercise tests, the authors present a commonsense approach in a compact yet highly readable text laced with clear diagrams and clinical examples. Things become a little more esoteric and perhaps premature in chapter 10 (exhaled nitric oxide) and some 'non-routine tests' are discussed in chapter 11.
With so much useful information packed into a small book (the pages are 18 x 11.5 cm) it is hard to be critical, but a few minor things caught my eye. There is inconsistency in the use of the symbols so beloved by respiratory physiologists (for example VD in the glossary and VD in the text). Despite stating that the book uses mm Hg rather than kPa units, chapter 13 uses kPa. Mixed spirometric patterns would be better introduced in chapter 1 rather than chapter 4. A pitfall not mentioned with oximetry is the dependence on adequate circulation. The delay in elevation in carbon dioxide tension in ventilation/perfusion mismatching has less to do with solubility and more to do with the complexity of the carbon dioxide-oxygen-haemoglobin relationships in hypoxia, and even multi-breath nitrogen clearance will only be linear if plotted semi-logarithmically.
The book can be read slowly in 90 minutes and this would be time well spent by candidates for postgraduate exams, advanced trainees in general and thoracic medicine, respiratory scientists and nurses. There are good references for further study and an excellent index. Whether it will be carried around in many pockets is another matter, but it is a compact reference which deserves a wide readership.
Honorary consultant physician, Department of Respiratory Medicine, The Royal Melbourne Hospital, Melbourne