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Pediatric Pulmonary
Function Lab
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Pediatric Pulmonary Function
Laboratory offers a full
range of lung funtion testing for children and adolescents in a child friendly
environment. Below are descriptions of the tests offered and the preparation
required for the test.
SPIROMETRY AND FLOW/VOLUME LOOP:
This test measures all the air that a person can blow out of their lungs after
a maximum inhalation known as the vital capacity (VC), as
well as how much air comes out in one second (FEV1). It is the most common
test used to screen for ventilatory abnormalities. It consists
of a series of breathing maneuvers repeated on a machine using a mouthpiece
while wearing nose clips. In addition, an inhaled
bronchodilator may be given to your child with some of the testing repeated
in order to compare the results. The complete test will take
approximately 30 minutes.
Preparation: Have your child avoid using rescue inhalers or nebulized treatments
(Albuterol, Proventil, Xopenex) 12 hours before
testing, long-acting inhalers (Serevent) 24 hours before testing, and any caffeinated
beverages 6 hours before testing.
LUNG VOLUME MEASUREMENTS:
Lung volume measurements including Total Lung Capacity, Vital Capacity and
Residual Volume are obtained by either gas dilution or
plethysmography to confirm restrictive lung disease or to identify air trapping
in children with severe airway obstruction. This test is
often done together with Spirometry and Flow/Volume loops. This test will take
approximately 15 minutes.
Preparation: Same as above for Spirometry and Flow/Volume Loops.
EXHALED NITRIC OXIDE TESTING:
This test requires breathing into a long tube connected to a machine that analyzes
the amount of nitric oxide present in a person’s breath.
Nitric oxide reflects the presence of inflammation in the lungs and is helpful
in guiding the treatment of asthma. This test will take
approximately 15 minutes.
Preparation: Please have your child avoid any meals with bacon or lettuce one
hour before testing.
IMPULSE OSCILLOMETRIC TESTING:
Airway resistance, reactance and compliance are measured with this modality.
These parameters are determined by having the child
breathe normally into a mouthpiece while wearing nose clips. It does not require
a maximum inhalation or forced exhalation and
therefore can be done in children as young as 3-4 years of age. This test is
helpful in identifying suspected airway obstruction and
improvements with bronchodilators. This test will take approximately 15 minutes.
Preparation: Same as above for Spirometry and Flow/Volume Loops.
METHACHOLINE CHALLENGE TESTING:
This test requires repeated breathing maneuvers (see Spirometry) after incremental
dosages of a medication called Methacholine. It is
used to determine abnormal airway reactivity and to confirm a diagnosis of
asthma. This test takes between 45 minutes and 1 hour.
Preparation: A therapist will be contacting you to discuss medications
and foods your child must avoid.
EXERCISE CHALLENGE TESTING
Asthma Protocol (1 1/2 hours) or Cardiopulmonary Metabolic Stress Test
(2 hours)
These tests are useful for assessing a child for exercise-induced shortness
of breath. When asthma is the most likely diagnosis the child
will be asked to repeatedly step up and down on a small set of stairs or run
on a tread-mill while we monitor your child’s heart rate and
oxygen saturation for approximately 10 minutes. Spirometry (see above) will
be measured before and after exercise. To assess the child
with exercise limitation that may not be due to asthma or to assess a child’s
level of fitness a more comprehensive study is performed
with extensive monitoring including 12-lead electrocardiogram, blood pressure,
ventilation, oxygen saturation and oxygen consumption.
For the exercise challenge tests please report to registration on the ground
floor in the hospital.
Preparation: See preparation instructions for Spirometry and Flow/Volume loops.
Your child should also avoid a large meal before the
test and wear comfortable clothing and shoes.
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