Novel techniques for assessing infant and pediatric lung function and structure

Abstract

Background: Voluntarily performed pulmonary function tests are used in adults and older children to assess lung dysfunction and changes in function that occur during disease progression and treatment. However, because infants are unable to comply with voluntary respiratory maneuvers, alternate testing methods are needed to allow similar progress in the treatment and prevention of respiratory disorders that begin in infancy.

Methods: Two new methods for assessing lung function and structure in infants and young children who are unable to perform voluntary respiratory maneuvers are described: raised volume rapid thoracoabdominal compression pulmonary function testing and controlled ventilation, high resolution computed tomography for lung imaging.

Conclusions: Both methods are performed in sedated, sleeping infants and depend on the induction of a pause in normal respiratory effort. This pause is produced by delivering several deep breaths via the child's nose and mouth using a facemask. The induced pause in respiration permits the performance of the respiratory maneuvers needed to acquire pulmonary function and high resolution computed tomography results in infants. These results are virtually identical with those obtainable during voluntary maneuvers performed by adults and older children. Together these 2 new methods permit evaluation of the functional and structural changes that occur in the lungs and airways of infants and young children with respiratory disease. These 2 novel techniques permit the investigation of lung disorders as they first develop early in life, thus optimizing opportunities for early intervention and prevention.