Cardiopulmonary Diagnostics Laboratory
Children's state-of-the-art Cardiopulmonary Lab provides comprehensive testing for a variety of pediatric respiratory, cardiac and metabolic disorders. Some of these tests are not offered anywhere else in the region. Obtaining an accurate diagnosis is critical to helping our doctors determine the proper and most effective treatment for your child's condition so that we can restore your child‘s health and help him or her have a normal childhood. For accurate information from these tests, it is crucial that the technician performing the test is specially trained in pediatrics. Children's respiratory practitioners have the experience and training necessary to ensure the best and most accurate results from your child.
The simplest pulmonary function study that is used to measure lung function is spirometry. This test measures the total amount of air that can be exhaled and how quickly that air can be forced out. This is a very valuable tool for trending chronic lung disease such as asthma, chronic bronchitis, cystic fibrosis and muscular dystrophy. This test is also used to diagnose asthma.
Plethysmography or Body Box Testing
The plethysmography or body box testing device is used to diagnose more complex disease processes such as restrictive lung disease and lung abnormalities that cannot be detected by spirometry alone. It can determine the amount of resistance to airflow in and out of the lungs as well as how quickly oxygen moves from the lungs into the blood stream. It also can detect if the lungs are trapping air.
Methacholine challenge is used to determine if your child has asthma or the severity of his or her condition. The patient performs spirometry before and after increasing levels of a drug called methacholine. Methacholine stimulates lung receptors, so when inhaled in sufficient concentrations, the airways constrict or become narrow. This occurs with much lower concentrations of methacholine in someone with asthma, thus aiding with the diagnosis.
Simple Exercise Study
A simple exercise study measures your child's oxygen saturation and blood pressure while your child walks, runs or bicycles at a comfortable pace. This study can be performed to simply monitor the patient for adequate oxygen level during exercise or can be performed with spirometry measurements. We can also assess for tightening of the airways with exercise that occurs with exercise-induced asthma by combining this test with spirometry.
Six-Minute Walk Study
The pulse rate and oxygen saturation of your child are monitored while he or she walks along a path of known distance as fast as he or she can comfortably walk accompanied by a trained respiratory therapist. The total distance walked in six minutes is then compared with normal values or the child's previous values. This is a valuable aid in determining disease severity or progression and also response to treatment.
Exercise Metabolic Study
An exercise metabolic study is a complex study that involves the measurement of oxygen saturation, blood pressure, heart rate and rhythm, oxygen consumption and carbon dioxide production during exercise. The study can reveal if there is a cardiac and/or pulmonary limitation to exercise and is usually performed with spirometry. This study is important for monitoring and evaluating certain cardiac and respiratory diseases for which limitation with exercise could indicate the need for surgical or other intervention. This includes conditions such as valve replacements, heart transplants or lung transplants.
Laryngoscopy is a procedure in which a thin, long scope is introduced through one side of your child's nose and then slowly passed through the nasopharynx and into the back of the throat. When in the nose, the adenoids can be viewed as well as any narrowing of the nasal passage. When the scope is passed through the back of the throat the tonsils can be seen, as well as the voice box (larynx) and movement of the vocal cords. This procedure can help determine if there is any cause of upper airway obstruction or narrowing of the airway at or above the vocal cords. This can be performed while your child is awake and at rest, but also can be done with exercise.
Multichannel Pneumocardiograms & Trend Oximetries
A trend oximetry is a simple study used to evaluate your child's oxygen level during sleep. The test records heart rate, pulse rate and oxygen saturation.
Multichannel pneumocardiograms are more complex and monitor your child's breathing pattern, airflow, oxygen saturation and heart rate. These are used to help diagnose upper airway obstruction and/or abnormal breathing patterns that could lead to oxygen desaturation.
Finding out what you are allergic to is the first step to providing effective allergy treatment. When combined with a detailed medical history, allergy testing can identify the specific things that trigger your child's allergic reactions. Allergy testing can be done as skin tests or as blood tests.
During allergy skin testing, a drop of a suspected allergen is pricked onto the surface of your child's skin. Skin testing can be performed to many environmental allergens, animals and foods. The testing is done quickly and causes minimal discomfort and can be performed on infants as well as older children. If your child is allergic, redness and swelling will develop at the test spot, providing you with results within a few minutes.
An allergy blood test (RAST testing) may be recommended if your child:
- Is taking a medicine that can interfere with skin testing, but cannot be stopped for a few days.
- Suffers from a severe skin condition.
- Has a severe food allergy that needs to be followed over a long period of time with a numerical value.
The sweat test is the best test overall for diagnosing cystic fibrosis when it is performed by experienced and trained technicians. The Cystic Fibrosis Foundation recommends that this test only be done at an accredited Cystic Fibrosis Center like that at Children's Hospital & Medical Center. People with cystic fibrosis have an increased amount of chloride or salt in their sweat. This test measures the amount of chloride in the sweat. There are no needles involved in the procedure. In the first part of the test, a colorless, odorless chemical, known to cause sweating, is applied to a small area on an arm or leg. An electrode is then attached to the arm or leg and a weak electrical current is applied to the area to stimulate sweating. Individuals may feel a tingling sensation in the area or a feeling of warmth. This part of the procedure lasts approximately five minutes. The second part of the test consists of cleaning the stimulated area and collecting the sweat on a piece of filter paper or gauze or in a plastic coil. Thirty minutes later, the collected sweat is sent to the laboratory for analysis. The entire procedure takes approximately one hour.