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Published on: February 2, 2024
[Pulmonary function test: The testing of children]
N Beydon1, R Abou Taam2, C Delclaux3
1Inserm U938, unité fonctionnelle d'explorations fonctionnelles respiratoire et somnologie, centre de recherche Saint-Antoine, hôpital Armand-Trousseau, Sorbonne université, AP-HP, 75012 Paris, France.
Insights
Pulmonary function tests (PFTs) aid in diagnosing and monitoring pediatric asthma and other respiratory conditions from age three. Proper techniques, equipment, and trained staff ensure accurate results for prognosis and intervention.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Context:
- Pulmonary function tests (PFTs) are crucial in pediatric care, primarily for asthma diagnosis and follow-up.
- Assessing respiratory symptoms and functional impairment aids in establishing prognosis and guiding preventive strategies.
Purpose:
- To outline the requirements and methodologies for performing PFTs in children aged three and above.
- To detail the progressive development of PFT techniques suitable for pediatric patients as they mature.
Summary:
- PFTs can be initiated from age three with appropriate techniques, equipment, and trained personnel.
- Early PFTs include tidal breathing measurements (Rrs, Rint, sRaw) and functional residual capacity.
- As children mature, more complex tests like spirometry and plethysmography become feasible, adhering to international pediatric PFT guidelines.
Impact:
- Ensures accurate and reproducible PFT results in children, crucial for effective respiratory disease management.
- Facilitates early and precise diagnosis, prognosis, and tailored interventions for pediatric respiratory conditions.
- Standardizes pediatric PFT practices, improving the quality of care and research outcomes in pediatric pulmonology.
Abstract:
In paediatrics, the pulmonary function test (PFT) is most often performed to support the diagnosis or in follow-up of asthma patients. Whatever the pathology responsible for respiratory symptoms and/or functional impairment, repeated PFTs make it possible to establish a prognosis (pulmonary function trajectories…) and to orient preventive interventions. PFT can be performed routinely from the age of three years, provided that the following requirements are met: suitable techniques and equipment, staff trained to apply the techniques and to receive young children, reference values for each technique indicating the limits of normal values and of between-test significant variation. From the age of three, children can be subjected to tidal breathing measurement of: resistance of the respiratory system (oscillometry, Rrs; airflow interruption, Rint) or of airways specific resistance (sRaw) and functional residual capacity (by applying a dilution technique). With maturity, the child will become capable of mobilizing his or her slow vital capacity to measure total lung capacity (TLC), once again by applying a dilution technique, then later by breathing against a closed shutter (plethysmography TLC and Raw). Finally, the child will be able to carry out forced expiration (forced spirometry) along with all of the other PFTs. It is important to take into account the paediatric adaptations specified in the international recommendations regarding the performance, reproducibility and quality of PFTs targeting this population.
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