Pulmonary function testing in the critically ill neonate, Part III: Case studies

Accurate monitoring of respiratory status is of vital importance for the bedside nurse caring for the critically ill neonate. Pulmonary function testing can be utilized to effectively diagnose and quantitate lung disease in infants. Data obtained can be integrated into the nursing assessment and facilitate appropriate nursing interventions. The case studies provided in Part III of this series illustrate the utility of such testing in neonates with a range of illnesses and different diagnostic and therapeutic dilemmas. Case study one is an infant with chronic lung disease complicated by bronchospasm, case study two is an infant with bronchomalacia, and case study three demonstrates fine tuning of the ventilator in an infant with respiratory distress syndrome. Every study describes the usefulness of pulmonary function testing on a specific patient, each with different pulmonary pathology. These case studies, and the discussion in parts I and II of this series, illustrate the value of integrating pulmonary function data with ongoing clinical assessment to optimize the care of the sick or convalescing neonate. Tests ordered on a routine and/or as-needed basis will provide detailed information on the infant's pulmonary status that may be readily available at the infant's bedside. The neonatal nurse's involvement in requesting, performing, and interpreting these tests may enhance the treatment of the infant in intensive care.