Pulmonary

Possible Treatments

Pulmonary function tests are a series of tests, which evaluate how well your lungs are performing.

Staffed by Licensed Respiratory Care Practitioners, pulmonary performs many tests that help physicians evaluate a patient’s lung health. “Pulmonary function tests”, usually called PFT’s are the most frequently ordered pulmonary lab tests. Different types of PFT’s can be performed depending on the age of the child. Each test requires a certain level of cooperation for the test to be successful and accurate. Generally, PFT’s are ordered within the following guidelines:

• Ages 8 and older: Spirometry every visit, lung volumes as needed
• Ages 6 & 7: Spirometry each visit
• Ages 3, 4 and 5: Spirometry as able (many this age cannot correctly perform test)
• Ages up to 3: Infant pulmonary function testing

Infant Pulmonary Function testing is done in the main pulmonary lab. When patients are old enough to cooperate, they will be testing in either the pulmonary lab located on the second floor in the main hospital or the satellite pulmonary lab, which is accessible in the Sturgis building.

State-of-the-Art Lung Function Tests

Pulmonary function tests, called PFTs, are tests that see how well your lungs work. They are the most often ordered pulmonary lab tests. Our Pulmonary Clinic is staffed by Licensed Respiratory Care Practitioners and performs many tests to help physicians check a patient’s lung health. To accurately diagnose and treat lung conditions in children, we offer pulmonary function tests.

Diagnostic Tests

• Body Plethysmography

  • Around 8 years of age, patients usually are able perform a more difficult test called body plethysmography which is often called “a body box study”. This nickname comes from the appearance of the equipment, which resembles a phone booth with a bench seat inside. The patient sits inside the box and breaths on a mouthpiece. Chest movements and changes in breathing pressures are measured, so the computer can calculate lung volumes. This test shows the total amount of air in the lungs and gives a more complete picture of a patients’ breathing function. This test takes about 20 minutes and will be performed at least once a year during annual visits.
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• Bronchoscopy

  • This test is performed while a patient sedated by a pediatric pulmonologist and is not available as part of a clinic visit. A bronchoscopy consists of inserting a long, thin tube (usually through the nose) through the upper airway into the lungs. The physician can look at the surface of the lungs and take sputum specimens. This test may help find an infection or other lung problem. A CF patient may never need a bronchoscopy. It is performed only when a problem persists that cannot be identified by other means.
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• Cold Air Challenge

  • The technician will teach your child a few different ways of breathing. First, your child’s baseline lung function will be tested. During this part your child will blow into a tube, using effort as if blowing out birthday candles. Next your child will breathe cold air through a special breathing circuit using a mouthpiece similar to what a scuba diver uses. The air will not feel cold on your child’s throat or mouth. After breathing in the cold air your child will repeat the first set of breathing tests to check for a change with the cold air. Your child will then be given a bronchodilator (medicine that helps open the small airways in the lungs). This medicine is given either as an inhaler or a nebulizer treatment. Some children may notice a faster heart rate for a short time after taking the medicine. The technician will then have your child repeat the first breathing test to check for any change with the medicine.
     

• Cough Peak Flow

  • The cough peak flow test monitors expiratory muscle weakness and bulbar involvement. The CPF is the speed of air coming out of the lungs after a cough, usually after taking in a very deep breath.
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• Diffusion Capacity

  • The diffusion capacity test measures the transfer of gas from air in the lungs to the red blood cells in lung blood vessels.
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• Exercise Induced Bronchoconstriction Study

  • The exercise-induced bronchoconstriction study is a test to measure exercise-induced bronchoconstriction (EIB) or acute airway narrowing that occurs as a result of exercise.
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• Helium Dilution

  • In some instances, the helium dilution study is used to evaluate lung volumes instead of the body box. It requires quiet breathing on a mouthpiece for 3-5 minutes followed by a full inspiration and expiration. This test may not provide more specific results for some patients with CF. It is usually used for patients that have a difficult time tolerating the body box study and to compare body box study results.
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• Lung Volumes

  • Lung volumes is a test that measures the total size of your lungs (how big they are) and how the air is distributed through the lungs.
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• Maximum Expiratory Pressure

  • The maximum expiratory pressure test measures maximal expiratory pressure.
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• Maximum Inspiratory Pressure

  • The maximum inspiratory pressure test measures maximal inspiratory pressure.
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• Pre Post Bronchodilator Study

  • This test uses spirometry to see if the narrowed airways caused by asthma and other respiratory diseases can be reversed.
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• Six Minute Walk Test

  • This test is performed to determine how exercise affects your lung function. You will have a lung function test before and after you exercise to see if there is a change in lung function.
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• Spirometry and Bronchodilator Response

  • During Clinic: The most common PFT performed is basic “spirometry”. This test checks the volumes and flow rates the patient is capable of producing by forcing (blowing) air out of their lungs into a mouthpiece. The test results can be compared at each visit to determine if lung function is staying the same, improving, or getting worse. A nose clip is used to keep air from coming out of the nose, so all the air goes into the mouthpiece. Three consistent forced expirations are required for a good test. A respiratory therapist in the pulmonary lab area will coach and encourage the patient during the test to get the best effort. The test takes about 20 minutes. Sometimes, the test is repeated after giving a treatment with a bronchodilator (Albuterol) to see if breathing changes with the medicine. Spirometry can help evaluate if a change in therapy is needed at home.
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  • During Admission: Patients admitted to the hospital perform PFT’s soon after admission and usually several more times before going home (depending on the length of stay in the hospital). This is one way to evaluate how well a patient is improving during the hospital stay and decide when they are well enough to go home.
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• Sweat Testing

  • The most reliable way to diagnose cystic fibrosis is to analyze the chloride (salt) contained in sweat. It is important to have a sweat test using the method approved by the Cystic Fibrosis Foundation for both collection and analysis. “Screening tests” may be unreliable.