Pulmonary Function Testing (PFT)
Pulmonary Function Testing is a broad range of tests that measure how well the lungs take in and exhale air and how well they transfer oxygen into the blood. Miller Children’s Hospital has a pulmonary function testing laboratory that is designed just for kids and allows pulmonologists to perform a variety of pulmonary function tests on children and adolescents, including infants. Miller Children’s is one of only a handful of children’s hospitals on the West Coast to offer infant pulmonary function testing.
These tests include:
Infant Pulmonary Function Testing
Infant pulmonary function testing measures a variety of pulmonary variables in those who are too young to perform, comprehend or comply with necessary instructions for conventional pulmonary diagnostic procedures. Most of the infant pulmonary function testing is done in the pulmonary function testing (PFT) laboratory, because children are typically tested while sleeping or sedated. The child may have an artificial airway in place and could be either spontaneously breathing or mechanically ventilated.
Benefits of infant pulmonary function testing:
- Aids in diagnosis of lung disorders (e.g., reactive airways disease)
- Helps doctors follow the natural history of lung growth or diagnose diseases presenting in infancy (e.g., cystic fibrosis)
- Evaluates therapeutic responses to medication or physical or respiratory interventions
- Predicts the risk of subsequent pulmonary dysfunction based upon initial testing
Infant pulmonary function testing is critical, because it allows for early detection of a pulmonary condition at as young as just a few months old. Once a condition is diagnosed treatment can begin as early as possible to help manage the infant’s condition at an early age.
Spirometry is a simple lung function test that measures lung volume as a function of time; it can be used to determine lung volumes or to gain information about maximal expiratory flow rates. The information that is gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases, especially asthma and chronic obstructive pulmonary disease (COPD).
In a spirometry test, a child breathes into a mouthpiece that is connected to an instrument called a spirometer. The device records the amount and the rate of air that is breathed in and out over a specified time. Some of the test measurements are obtained by normal, quiet breathing and other tests require forced inhalation or exhalation after a deep breath.
Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue or by abnormalities of the muscles or skeleton of the chest wall.
Infants and children with pulmonary disease may have lower partial pressure of arterial oxygen. Miller Children’s pulmonologists, who care for infants and children with borderline oxygen saturations at their local altitude, advise parents about travel to a high elevation. High-altitude testing can determine if an infant or child can safely travel to high-altitude destination.
Exercise cardio-metabolic-pulmonary testing is performed on children who often have problems with shortness of breath. The test can indicate whether a problem is psychological or physiological and can determine whether the cause is a cardiology or pulmonary disorder or whether it is secondary to muscle disease or deconditioning. If it’s a cardiology condition, the pulmonary team works closely with the cardiac care team to diagnose and treat.
Identifying Cardiometabolic disease
The first step in identifying whether a patient is at risk for cardiometabolic disease is to conduct a history, physical examination and perform screening laboratory testing.
Pulmonologists along with the cardiology care team measure:
- Height and weight, to assess if a patient is overweight or obese
- Waist circumference, to determine if visceral obesity is present
- Blood pressure to determine if a patient has hypertension
- Lipids and glucose to determine if there are changes in metabolic parameters
Once these tests are completed, a patient’s risk can be estimated and treatment (if necessary) can begin. Clinical guidelines can be used to determine if a patient falls out of acceptable and recommended standards for body composition and metabolic parameters.
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