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Assessment of functional abnormalities in infants and children with lung disease
1Department of Pediatrics, University of Berne, Inselspital, Switzerland.
Insights
Pediatric lung function testing requires specialized methods for infants and young children. Various techniques assess respiratory health from infancy through childhood, addressing challenges in cooperation and age-specific limitations.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Infant and child lung function testing presents unique challenges due to developmental stages and cooperation levels.
- A critical age gap (2-5 years) exists where standard lung function testing is often not feasible.
- Objective evaluation of respiratory conditions in early childhood is crucial for timely diagnosis and management.
Purpose of the Study:
- To review and outline the diverse range of lung function testing techniques applicable to infants and children.
- To highlight the importance of these tests in diagnosing and monitoring pediatric respiratory diseases.
- To address the limitations and specific considerations for testing lung function across different pediatric age groups.
Main Methods:
- Overview of infant lung function testing methods including spirometry, squeeze-jacket, forced oscillation technique, occlusion technique, whole-body infant-plethysmography, multibreath nitrogen washout (MBNW), and interruption technique.
- Description of lung function techniques for older children, encompassing spirometry, whole-body plethysmography, MBNW, interruption technique, bronchial challenge tests, and exercise testing.
- Emphasis on adapting methodologies to overcome challenges related to sleep requirements in infants and cooperation in young children.
Main Results:
- A comprehensive array of techniques exists for assessing lung function in infants, aiding in the evaluation of conditions like infant respiratory distress syndrome (iRDS), hyaline membrane disease (HMD), broncho-pulmonary dysplasia (BPD), wheezy bronchitis, and cystic fibrosis (CF).
- Established methods are available for children, allowing for objective assessment of lung function, including airway reactivity and exercise capacity.
- The reviewed techniques provide objective data to complement clinical findings in pediatric respiratory care.
Conclusions:
- Specialized lung function tests are essential for the objective assessment of respiratory health in infants and children.
- The selection of appropriate testing methods must account for the child's age, developmental stage, and ability to cooperate.
- These techniques are vital tools for diagnosing, managing, and monitoring a spectrum of pediatric pulmonary conditions throughout early life.
Abstract:
Lung function testing in infants and children has to cover a wide palette of various investigational procedures and the fact that babies can predominantly only be tested asleep and young children may not cooperate accurately must be taken into account. There is still a life-span between 2 and 5 years in which lung function testing is impossible. Different techniques for infants lung function testing (spirometry, squeeze-jacket method, forced oscillation technique, occlusion technique, whole-body infant-plethysmography, multibreath nitrogen washout (MBNW), interruption technique), which helps already in early childhood to evaluate objectively clinical findings in infants after infant respiratory distress syndrome (iRDS) with/or without hyaline membrane disease (HMD), developing or not developing broncho-pulmonary dysplasia (BPD), wheezy bronchitis or cystic fibrosis (CF) are available. Lung function techniques in children include spirometry, whole-body plethysmography, multibreath nitrogen washout (MBNW), interruption technique, bronchial challenge tests, exercise testing.