Pulmonary function testing in the critically ill neonate, Part I: An overview

Respiratory insufficiency, a frequent problem encountered by the critically ill neonate, has many etiologies. Pulmonary function testing can effectively diagnose, quantify, and qualify the dysfunction so as to better define a prognosis and guide appropriate therapy. Recent advances in computer-assisted technology and miniaturization of equipment now allow simple, reproducible, and rapid neonatal pulmonary function assessment at the bedside. The indications for, and benefits of, pulmonary function testing vary with gestation, age, and clinical condition of the infant. The overall description of the pulmonary function profile is discussed in this article. The general questions and approaches utilized for routine testing, the initial pulmonary function profile, and evaluation of the acutely ill infant and that of the convalescing preterm are addressed. The expertise of the intensive care nurse is invaluable in ensuring that safe, accurate, and reproducible data are obtained. The nurse can then use the data to alter the infant's care plan and to determine the necessity and timing for retesting. Specific information on methodology and examples of specific tests are given in related articles (Parts II, Vol. 13 No. 2 and III, Vol. 13 No. 4, respectively). A complete knowledge of pulmonary function assessment is important for any nurse caring for critically ill neonates.