Testing in ChildrenPulmonary function tests (PFT's) measure how well your child can move air in and out of his or her lungs. PFT's, also called breathing tests, will help your healthcare provider tell if your child has lung disease, how severe it is and what medications may help. Your child may be asked to do PFT's in your healthcare provider's office or in a pulmonary function laboratory (lab).
Specially trained staff will coach you and your child
record your child's peak flow reading at home or in
throughout the tests. Often the breathing tests are
your doctor's office. However, spirometry is a more
presented as a blowing game. Sometimes blowing a
accurate test to measure disease than just a peak
toy like a party horn can be used to help your child
practice what will be done during the breathing tests.
Your child may become tired or frustrated during
Before doing PFT's, your child's height will be
the test and this is common. Sometimes it takes
measured because his or her lung size is related to
several visits to the office or lab to practice the test
his or her height. Your child's test results can be
before your child can complete the test. Coughing
compared to the results of other children of the
during the test is to be expected. Tell your child that
same sex, age, and height, like the standard ranges
they may rest between blowing into the machine,
on a growth chart. Two common PFT's done in
in order to catch his or her breath.
children are spirometry and airway resistance tests.
Sometimes this test is repeated after your child
What is spirometry?
inhales medication. This test is called a post-
Spirometry is the most common lung function test
bronchodilator or bronchodilator response test.
done. It measures how much air is moved in and
What is a post bronchodilator or
out of the lungs and how fast the air moves. To get
bronchodilator response test?
the best results, your child will be asked to follow
Your healthcare provider may want to see if your
very specific instructions. Most children can do
child has an improvement in his or her breathing
spirometry by age 6, though some preschoolers are
after inhaling a bronchodilator (a medicine that
able to perform the test at a younger age.
opens the breathing tubes). Your child will be asked
Your child will be asked to wear a nose clip to
to breathe in a bronchodilator medicine (usually
keep him or her from breathing through his or her
albuterol or levalbuterol) after completing the first
nose during the test. Your child will then be asked
breathing test. About 15 minutes after taking the
to take in a deep breath and to blow the air out into medicine, your child will repeat the breathing test.
a mouthpiece that is connected to a computer. The
The results from the second test will be compared
computer measures how much and how fast the air
to the first test to find out if the medicine has
is blown out. Your child will repeat the test at least
improved your child's breathing.
two times to get their best, most consistent result. This test can take up to 30 minutes to complete.
Why shouldn't I give my child some
One of the tests measured during spirometry is
of their breathing medications before
your child's peak flow. The peak flow requires your
child to blow out as hard and as fast as they can.
Some breathing medicines will block the test from
This test gives a number like you get when you
showing whether your child's airways have a good
Am J Respir Crit Care Med. Vol. 189, P5-P6, 2014
ATS Patient Education Series 2014 American Thoracic Society
response. Ask the staff which medicines, if any, to
How can I help to make the breathing test
stop. Listed in the table below are bronchodilators
less stressful for my child and me?
by their generic name (in italics) and brand
1. Be patient with your child during the test.
name (the name assigned by the pharmaceutical
2. Explain to your child that the test does not hurt.
company). Note: the brand name of the medication
3. Explain to your child that the breathing test
can be different from country to country.
is being done to find out how to make their
Short acting bronchodilators such as albuterol or
levalbuterol or the combination inhaler albuterol/
4. Schedule the test at a time of day that your child
ipratropium (Combivent®) should not be given
is usually not tired or hungry.
for at least 4 hours prior to the test. Also, you
5. The staff will explain the test to you and your
may be told to stop giving your child a long
child. If you or your child does not understand,
acting bronchodilator (generic name/brand name)
ask the staff to repeat the instructions.
salmeterol/Serevent®, or formoterol/Foradil® or
6. If your child has a cold, sinus infection, or other
combination inhalers that include one of these
reason that makes them unable to take the test,
bronchodilators plus a steroid. Examples of these
let your provider and the office or lab know as
combinations are Advair® and Symbicort®. If your
soon as possible. They can decide whether the test
child is taking either of these medications, you may
should be performed or rescheduled.
be asked not to give this medication to your child from 12 to 24 hours prior to the test.
Authors: Stephanie Davis MD, Enrico Lombardi MD, Nicole Beydon
MD, Marianna Sockrider MD, DrPH, Bonnie Fahy, RN, MN, Suzanne
Lareau RN, MS, Rebecca Pettit PharmD.
ProAir®, Proventil®, Ventolin®
(lasts about 4 hours) levalbuterol tartrate
American Thoracic Society
Foradil®, Oxeze®, Oxis®
(lasts about 12 hours) salmeterol
albuterol sulfate /
formoterol fumarate + Symbicort®
plus an inhaled
4 If you are concerned about your child's
formoterol fumarate + Dulera®
breathing, ask your health care provider about having your child's lung function tested.
Advair®, Dulera®, Seretide®
4 Prepare your child for PFT's by explaining the
test before arriving at the office or lab.
What are airway resistance tests?
Airway resistance tests are breathing tests that help
4 Ask at least 48 hours before the scheduled test if
there are any medicines that should not be taken
your health care provider evaluate the size of your
by your child before the test.
child's breathing tubes (airways). These tests are easy for preschool children (between 3-6 years of age) to
4 Plan extra time when your child is doing lung
do. For these tests, your child does not have to blow
function tests. Several tests and rest periods may
out hard like in the spirometry test. Your child will
be needed to get the best results.
be asked to sit up straight and breathe quietly and
Health Care Provider's Contact Numbers/
regularly into a mouthpiece. They will be asked to
wear a nose clip and breathe with their lips sealed tightly around the mouthpiece. In some cases, your child's cheeks may be held by the technician's or your hands during the test. The test takes only a few minutes to do.
The ATS Patient Information Series is a public service of the American Thoracic Society and its journal, the AJRCCM. The information appearing in this series is for educational purposes only and should not be used as a substitute for the medical advice one one's personal health care provider. For further information about this series, contact J.Corn at [email protected]
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