It is very important for you to check your lung function daily after you have had a lung
transplant. A drop in spirometry is the easiest way to catch a rejection. You have been given an
AM1 Plus so that you can monitor your lung function. With the AM1 Plus, you will be watching
two values. These values are:
ξ Forced Expiratory Volume in One Second (FEV1): This measures the volume of air that
is blown out during the first second that you are forcing air out of your lungs.
ξ Peak Expiratory Flow (PEF): This measures how fast the air comes out of your lungs
when you force it out.
How to Use the AM1 Plus (AM1+)
Take the cap off the AM1+.
1. Press the gray key in the lower left hand corner that is labeled with a white circle. This
will turn on the AM1+.
2. Make sure you sit up very straight.
3. When you are ready to do your spirometry test, push the gray (OK) button with a green
circle on it in the lower right hand corner.
4. Take a very deep breath and exhale as fast as possible!” will show on the screen. You
now have about 15 seconds to complete the test.
5. As soon as this message is displayed, fill your lungs up with as much air as you can.
Once your lungs are full of air, blow all the air out of your lungs as fast and as hard as
you can until you cannot blow any more out.
6. When you have completed the test, the AM1+ will beep and display your spirometry
results. Use the up and down arrows to scroll through the results.
7. Now you need to do two more tests. When you are ready, push the “Menu” button in the
lower left hand corner and then the OK button in the lower right hand corner. The
spirometer will again prompt you to take a big breath in and blow out hard.
8. When you have completed the three tests, the results of your best FEV1 will be displayed
on the screen. Record the numbers that are displayed for the FEV1 and FVC on your
Spirometry Record sheet.
9. Shut your AM1+ off by pushing the on/off button in the lower left hand corner twice.
How to Check Your Spirometry Results
You must test your spirometry daily. You will be looking for a 10% decline in your results.
Patients often have no clue that they are rejecting their new lungs until the rejection has been
going on for a few days. Many patients who are going through rejection do not feel any
differently, but they do have a decrease in their lung volumes. The decrease in lung volumes
occurs because rejection causes swelling in the air passages of the lungs.
Swelling in the lungs may be caused by things other than rejection. For instance, a cold or
infection can also cause swelling. If you notice that you have a 10% drop in your spirometry
values, you need to call your transplant coordinator as soon as you can so that we can figure out
what is causing the drop. If it is rejection; the sooner treatment is started, the smaller the chance
that you will have any permanent damage.
To figure out if you have a 10% change:
1. Compare the “best” FEV1 value for today to the value that you got yesterday. If the
“best” FEV1 today is higher than the “best” for yesterday, good for you!
2. If your “best” FEV1 for today is lower than the “best” for yesterday, refer to your FEV1
3. To use the FEV1 Chart, find your FEV1 value from yesterday in column “A”. Now look
at the number next to it in column “B”. If the FEV1 value for today is equal to or less
than the value in column “B”, you have had a 10% change.
4. Now follow the same steps for your PEF values.
5. If you have had a 10% drop:
ξ Change the batteries of your spirometer.
ξ Repeat the spirometry and re-check the FEV1, and PEF values (steps 1- above).
ξ If your spirometry values are still down 10%, call your transplant coordinator as
soon as you can.
Three AAA batteries power the AM1+. If the screen appears to be dim, the spirometer will not
turn on, or you notice a 10% decline in your spirometry values, replace the three batteries in the
back of the AM1 Plus and repeat the spirometry test. If your spirometry values do not improve,
call your coordinator.
Spirometer Maintenance and Clinic Visits
Each time you come to transplant clinic you must bring your AM1+ and Spirometry Records
with you. During your clinic visits, the Respiratory Therapists will check the function of your
AM1+, clear the memory, and evaluate your spirometry data.
If you have any questions about using your spirometer, please contact Respiratory Care at
(608) 263-7050. All other questions should be sent to your transplant coordinator.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2016. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5863.