15.20 Buletin Explorare Functional A Ventilatorie

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Judeţul………………………………………………… Localitatea…………………………………….……… Unitatea sanitară………………………………………

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CNP BULETIN DE EXPLORARE FUNCŢIONALĂ VENTILATORIE (PLETISMOGRAFICĂ) Nr……… Data .............................. Numele……………………….Prenumele……….…….. Sexul M/F………………Vârsta………………. Domiciliul:judeţul……..………..localitatea……...… …. Str……………………………………….Nr…………… Trimis de : …………………………………………...… REZULTATE Actual Teo- % retic Capacitatea vit.(CV), ml Volumul rezidual (VR), ml Capacitatea pulmonară totală (CPT), ml Volumul gazos intratoracic (VGIT), ml VR / CPT VGIT / CPT Rezistenţa la flux în căile aerifere ( ), cm H2O/1/S Conductanţa căilor aerifere (GAW), l/cm H2O Conductanţa specifică (GAW/SIT) Volumul expirator maxim pe secundă (VEMS), ml VEMS *100 / CV Ventilaţia maximă (Vmax.), l Debitul expirator maxim de vârf, l/s Debitul expirator maxim la 50% CV (Vmax.), l/s

Faţă

15.20 ; A6 ; t2

Concluzii, recomandări : ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… ………………………………………………………… …………………………………………………………

a a a a l l z z Lucrat de : (numele, prenumele)

Semnătura şi parafa medicului,

……………………..

……………………. Verso

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