Pulmonary Function Testing: A Practical Guide to Its Use in Pediatric Practice

1986 ◽  
Vol 7 (8) ◽  
pp. 235-245
Author(s):  
Howard Eigen

Pulmonary function testing is a useful and important method by which to evaluate patients with or suspected of having lung disease. Pediatricians in the past have taken too little advantage of these techniques in their offices or through referral to pediatric pulmonary function laboratories and, when they have used them, have all too often relied on laboratories designed for adult patients. As with such tests as tympanometry and audiometry, pulmonary function testing should be incorporated into the daily practice of the modern pediatrician. The outlay for equipment is within the means of all pediatricians, and the charges to the patient for testing are quite reasonable, especially because they may be offset by savings from fewer emergency room visits and from a reduction in hospitalizations. One person in the office must function as "technician" and is referred to as such in this article. In most offices, this person will have other responsibilities as well, but having one person fill the role of pulmonary function technician will improve the reliability of the results of the pulmonary function tests performed. Although new techniques are being developed for testing young children and infants, these are beyond the scope of office practice because of the time and equipment they require.

2016 ◽  
Vol 02 (01) ◽  
pp. 16
Author(s):  
Luís Miguel Borrego ◽  
◽  
◽  
Mário Morais-Almeida ◽  
◽  
...  

Pulmonary function tests (PFT) are usually useful to confirm the diagnosis, as well as for guidance to therapy and also to clarify the prognosis of several respiratory diseases, but only recently it gained interest in preschool aged children. Published papers have shown the feasibility of respiratory function testing in preschool aged children, as in the context of clinical investigation, as in clinical daily practice, but more investigation is needed to demonstrate PFT usefulness, particularly in clinical correlation and prospective follow-up of preschool asthmatic children.


Author(s):  
Mathias Poussel ◽  
Isabelle Thaon ◽  
Emmanuelle Penven ◽  
Angelica I. Tiotiu

Work-related asthma (WRA) is a very frequent condition in the occupational setting, and refers either to asthma induced (occupational asthma, OA) or worsened (work-exacerbated asthma, WEA) by exposure to allergens (or other sensitizing agents) or to irritant agents at work. Diagnosis of WRA is frequently missed and should take into account clinical features and objective evaluation of lung function. The aim of this overview on pulmonary function testing in the field of WRA is to summarize the different available tests that should be considered in order to accurately diagnose WRA. When WRA is suspected, initial assessment should be carried out with spirometry and bronchodilator responsiveness testing coupled with first-step bronchial provocation testing to assess non-specific bronchial hyper-responsiveness (NSBHR). Further investigations should then refer to specialists with specific functional respiratory tests aiming to consolidate WRA diagnosis and helping to differentiate OA from WEA. Serial peak expiratory flow (PEF) with calculation of the occupation asthma system (OASYS) score as well as serial NSBHR challenge during the working period compared to the off work period are highly informative in the management of WRA. Finally, specific inhalation challenge (SIC) is considered as the reference standard and represents the best way to confirm the specific cause of WRA. Overall, clinicians should be aware that all pulmonary function tests should be standardized in accordance with current guidelines.


1994 ◽  
Vol 15 (10) ◽  
pp. 403-411
Author(s):  
Gary A. Mueller ◽  
Howard Eigen

Pulmonary function testing is an important tool in the evaluation of children who have or are suspected of having lung disease. Of particular importance, pulmonary function testing provides objective and reproducible measurements, which then can be used to follow the response to therapy. The measurements of air flow and lung volumes are the mechanical pulmonary function tests used most commonly. However, measurements of the efficiency of gas exchange also are considered a test of pulmonary function and can be assessed by such methods as arterial blood gas and oximetry. This article focuses on those tests readily available to the pediatrician in the office or hospital. Measuring pulmonary function regularly is analogous to measuring blood pressure in patients who have hypertension, allowing the physician to follow a measurement directly associated with the pulmonary disease process. As with other clinical tests, pulmonary function measurements are most effective when used to answer a specific question about the patient. For example, in a child who presents having a persistent cough and a family history of asthma, the diagnosis may be asthma, and the question "Does the child have airflow obstruction consistent with asthma?" can be answered by spirometry. Spirometry The parameters commonly measured in the assessment of respiratory function are lung volumes, air flows and timed volumes, and airway reactivity.


Author(s):  
Nataliia Slepchenko ◽  
Yuriy Mostovoy ◽  
Lesya Rasputina ◽  
Kostiantyn Dmytriiev

AAOHN Journal ◽  
1986 ◽  
Vol 34 (8) ◽  
pp. 366-369
Author(s):  
Eileen Burke-Klein

For the results of pulmonary function testing to be valid, the examination must be administered by a knowledgeable technician and the instrument must fulfill performance criteria. In general, most small to mid-sized industries rely upon local medical clinics to provide pulmonary function tests. Because of this, a survey was undertaken to study the pulmonary function testing services available at occupational medical clinics in a large metropolitan area. The purpose of this study was: 1. to determine the percentage of clinics complying with the program prerequisites mentioned above, and 2. to identify the other predictive characteristics of clinics more likely to meet these standards. A random sample of occupational medical clinics providing pulmonary function testing were selected for this study. Of the 31 clinics providing pulmonary function testing services, a random sample of 14 were chosen to perticipate; for these clinics, administrators and/or physicians were interviewed and testing equipment was examined. It was found that 17% of clinics employed certified technicians to conduct testing and 42% had instruments meeting performance specifications. Overall, only 8% of the sample met both prerequisites. No significant relationship was found between selected variables that it was hoped would identify clinics more likely to perform valid pulmonary function testing. It is believed that a larger sample size would be necessary to establish such significant correlations.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 129-130 ◽  
Author(s):  

Bronchoconstriction can occur in association with exercise in up to 15% of the general population, including nearly 100% of people with asthma, 35% to 40% of those with allergic rhinitis, and some who have no other evidence of allergy.1 This phenomenon, termed exercise-induced asthma (EIA), is manifested by coughing, choking, chest pain, easy fatigability, shortness of breath, wheezing, chest tightness, or any combination of these symptoms during, or especially after, exercise. In a child known to have asthma or nasal allergies, the diagnosis of EIA can usually be made on the basis of history alone. Repeated episodes of increased difficulty breathing or cough in association with physical exertion should be assumed to be EIA until proved otherwise. Sophisticated pulmonary function testing is not necessary in the majority of cases. In the atypical case, pulmonary function testing, often in conjunction with an exercise challenge, can confirm the diagnosis. Exercise-induced asthma is less likely to occur in a child whose asthma is well controlled,1 a goal accomplished best with attention to the role of airway inflammation as well as bronchoconstriction.2 Fortunately, EIA can be controlled in most athletes by the inhalation of a β2-agonist bronchodilator (eg, albuterol), cromolyn sodium, or both 15 to 30 minutes before exercise. These safe medications come in several different forms, but the most convenient for patients older than 2 or 3 years is the pressurized metered-dose inhaler (MDI), which is especially easy to use with the addition of a spacing device. Cromolyn has never been thought to be effective as an ergogenic (performance-enhancing) aid,3 and only two studies have suggested the possibility that albuterol is ergogenic.4,5


2021 ◽  
Vol 96 (3) ◽  
pp. 209-217
Author(s):  
Sung Yoon Lim ◽  
Ho Il Yoon

Spirometry, also called office-based pulmonary function testing, is a useful tool for diagnosis and classification of lung disease. Here, we outline a simple stepwise approach for interpretation of spirometry results. The first step is to determine the forced expiratory volume in a one second/forced vital capacity (FEV1/FVC) ratio. If airflow is limited, a bronchodilator is administered followed by reassessment. The next step is to determine whether FVC is low; an observed decrease in FVC indicates a restrictive patten. For patients with obstructive disease, inhalation medication is needed. Therefore, this review also describes the most appropriate inhalation device for each patient and the correct use of the device to maximize inhalation therapy benefits.


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