Clinical Applications of Pediatric Pulmonary Function Testing-Introduction to the Series

摘要

Pulmonary function tests are key components of the evaluation and management of children with chronic lung diseases such as asthma, bronchopulmonary dysplasia (BPD), cystic fibrosis, and restrictive chest wall disorders. The well-known maxim that "children are not just little adults" certainly extends to the pediatric pulmonary function laboratory, where infants are sedated with chloral hydrate for a test that would take 10 min in a cooperative adolescent, toddlers watch "Sponge Bob" videos while performing tidal breathing maneuvers, and preschool children may be seen blowing party favors to learn forced expiratory maneuvers. The choice of the optimal test for a specific patient depends not only on developmental abilities, but also on the underlying pathophysiology of the disease process being evaluated. Does the patient have obstructive disease or restrictive disease? How is bronchodilator responsiveness best evaluated in a 2-year-old? How can lung volumes be assessed in a patient too young to cooperate with plethysmography? Understandably, the busy practicing pediatrician or pediatric pulmonologist may feel bewildered by the plethora of lung function tests available and unclear how best to utilize these tests in clinical practice.