Pulmonary Function

What is pulmonary function?

Pulmonary function is the medical term for how well the lungs are working.

If your child has problems breathing, they could have a pulmonary (lung) disorder or infection that requires treatment. If so, Dr. Susarla conducts pulmonary function tests to assess your child’s breathing problems and help determine the cause.

What conditions might cause pulmonary function problems?

Some of the conditions that cause pulmonary function problems in children are:

• Recurrent pneumonia
  
• Exercise Related Breathing Disorders
  
• Neuromuscular Disorders affecting breathing
  
• Asthma
• Bronchopulmonary dysplasia
• Chronic aspiration
• Chronic lung disease
• Difficult-to-treat asthma
• Recurrent pneumonia
• Respiratory disease
• Sleep apnea
• Tracheomalacia
• Childhood interstitial lung disease (chILD)
  
  

If your child is struggling to draw breath, that’s a clear sign they need medical attention. Your child could also have other respiratory symptoms caused by pulmonary function disorders. Symptoms that can indicate lung problems include noisy breathing, wheezing, and a chronic cough.

What pulmonary function tests might my child need?

Your child might need several pulmonary function tests if they’re having breathing problems. The simplest is the pulse oximetry test, which estimates the oxygen levels in your child’s blood. A probe on the end of your child’s finger, or possibly somewhere like the ear, and a sensor measures the oxygen levels in the blood. Pulse oximetry is painless and entirely noninvasive.

Other pulmonary function tests your child might need include:

Spirometry

This is a standard "forced" exhalation test used frequently to assess for asthma in children 6 years old and up. It is often performed with a "bronchodilator challenge" where the child is provided with inhaled medication and a repeat test 15 minutes afterwards. 

Impulse Oscillometry

Younger children who cannot perform spirometry, and some children with airway conditions not adequately diagnosed by spirometry can benefit immensely from this in office test of airway resistance. It requires only 30 seconds of "tidal" breathing.

Lung volume tests

Lung volume tests are similar to spirometry tests, but they take place in a small, enclosed area that has transparent walls. These tests provide a precise measure of the volume of air your child can hold in their lungs.

Lung diffusion capacity

Lung diffusion capacity measures how efficiently oxygen is getting into your child’s blood. They have to breathe in and out at a normal rate for several minutes using a tube. Dr. Susarla might also want to take blood to check the levels of hemoglobin, a protein that transports oxygen around the body.

Arterial blood gas test

An arterial blood gas test measures the levels of oxygen and carbon dioxide in your child’s blood. It requires a sample of arterial blood, usually taken from the wrist.

Fractional exhaled nitric oxide test (FeNO)

This test measures the quantity of nitric oxide in the air your child breathes out. Your child needs to exhale steadily into a tube connected to a portable measuring device. High nitric oxide levels can indicate inflammation in the lungs.

Infant pulmonary function testing (iPFT) is a way of measuring a very young child’s breathing. It involves your child having sedation and going into a special machine that measures how quickly air flows through their airways, how much air is in their lungs, and how stiff their lungs are.

Exhaled nitric oxide is the only "point of care" biomarker validated in diagnosing and managing asthma. It particularly helpful in identifying signs of active inflammation associated with asthma, and important tool in predicting risk for future asthma exacerbations. Children can perform this test easily with a 10 second period of exhalation. 

Some conditions such as recent viral infections can influence testing results. in addition some foods consumed prior to visit can cause false positives (nitrites, cruciferous vegetables).

MINIBOX Lung Volume Assessment

Though spirometry is a standard diagnostic test of lung function, it may miss other lung conditions associated with low lung volume including conditions and may not be sufficient to diagnostic the severity of certain obstructive lung conditions. This test provides that option without the need for the child to sit inside larger claustrophobic chambers. 

Exercise Testing

Treadmill testing performed in office and accompanied with lung function testing before and after the test can be helpful in identifying exercise related conditions such as exercise induced bronchospasm. 

To find out more, call Houston Specialty Clinic today.

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