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Special Considerations for Pediatric Patients

  • Graham L. Hall
  • Daniel J. Weiner
Chapter
Part of the Respiratory Medicine book series (RM)

Abstract

The application of lung function testing in pediatric patients has generally fallen into two categories, assessment of lung function for clinical diagnosis and management and research linked to the introduction of new methodologies and improving our understanding of respiratory pathophysiology in infants, young children, children, and adolescents.

Clinical testing occurring in established respiratory laboratories has generally been limited to those school-aged children and young people able to cooperate with standard clinical testing protocols including spirometry, plethysmographic lung volumes and measures of gas transfer, as well as assessment of airway reactivity through bronchodilator reversibility and inhaled airway challenge testing (primarily methacholine). Many clinical laboratories also perform cardiopulmonary exercise testing and assessment of exercise-induced bronchoconstriction. Within these laboratories, assessment of respiratory pathophysiology of lung disease using more advanced methods or in challenging patient populations, such as infants and young children, has been hampered by a lack of expertise, limited range of commercially available equipment, and age-appropriate testing and interpretation guidelines.

Among more specialized respiratory laboratories, there is a rich tradition of the development and validation of “new” lung function tests, many of which have subsequently migrated into clinical practice with emergence of commercially available equipment and guidelines for their clinical use. An example of this development is the raised volume rapid thoracic compression technique (or infant spirometry) which grew from research in Australia, England, and the United States and is now commonly used within clinical laboratories in some countries.

Underpinning the use of any lung function test in pediatric patients is the need to recognize that protocols and guidelines developed based on research and clinical practice in adult laboratories does not automatically mean a direct translation into pediatric practice can occur. This chapter will highlight some of these pediatric issues, as they apply to children. For in-depth details on specific tests, readers are directed to the specific chapter on that methodology.

Keywords

Pediatric Infant pulmonary function tests Rapid thoracic compression Raised volume rapid thoracic compression Interrupter technique 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Children’s Lung HealthTelethon Kids InstituteSubiacoAustralia
  2. 2.School of Physiotherapy and Exercise Science, Faculty of Health ScienceCurtin UniversityBentley, PerthAustralia
  3. 3.University of Pittsburgh School of Medicine, Pulmonary Function LaboratoryAntonio J. and Janet Palumbo Cystic Fibrosis Center, Children’s Hospital of Pittsburgh of UPMCPittsburghUSA

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