Pulmonary care

If a breathing disorder is suspected, your pediatric pulmonologist will take a complete medical history and perform a physical examination. Your doctor may order one or more of the following tests to help determine the cause of your child’s breathing problem:

• Apnea study — A test to monitor breathing effort, heart rate and oxygenation
• Blood gases — Tests used to measure the amount of oxygen, carbon dioxide and acid in the blood
• Blood tests — Tests in which small samples of blood are taken, often to analyze the carbon dioxide and oxygen levels in the blood
• Chest X-rays — A test that uses electromagnetic energy beams to create images of organs, bones and internal tissue
• Electrocardiogram (EKG) — A test that records the electrical activity of the heart to rule out heart problems that may cause a breathing complication
• Pulmonary function tests/spirometry — A test that uses a machine, called a spirometer, to measure lung function when your child breathes
• Peak flow monitoring (PFM) — A device that measures the amount of air your child can blow out of the lungs
• Pulse oximetry — A test that uses a device, called an oximeter, and small, painless sensors to measure how much oxygen is in the blood
• Sputum cultures — A laboratory test that evaluates material coughed up from the lungs into the mouth to determine the presence of an infection
• Sweat (chloride) test — A test that measures chloride levels in sweat by placing a solution on the skin, attaching electrodes and collecting sweat after the skin is stimulated
• Transillumination — A test that uses a fiber-optic light probe to diagnose an air leak in organs or tissues of newborn babies

Once an appropriate diagnosis has been made for your child’s breathing problem, your pediatric lung specialist will create a treatment plan to help your child live a healthy, full life. Your child’s treatment plan will be based on their age, the diagnosis, their symptoms and your preferences. The breathing disorder treatment plan may include:

• At-home treatments
  • Avoiding secondhand smoke
  • Cool mist humidifier
  • Increased fluid intake
  • Keeping your child as quiet and calm as possible to decrease breathing effort
  • Saline nose drops
  • Taking your child outside into cool, dry, night air
• Continuous positive airway pressure (CPAP) — A breathing machine that helps keep the lungs open
• Endotracheal (ET) tube — A tube placed into the windpipe to protect the airway
• Extracorporeal membrane oxygenation (ECMO) — A special technique for persistent pulmonary hypertension where blood is pumped through an artificial lung where oxygen is added and carbon dioxide is removed
• Pediatric immunizations — Shots given to fight lung infection from respiratory syncytial virus (RSV) and influenza
• Inhalation of nitric oxide — To help dilate the blood vessels in the lungs
• Intravenous fluids and nutrition — To help the lungs of premature babies grow
• Mechanical breathing machine — A machine that helps your child breathe when he or she cannot breathe on his or her own
• Medications
  • Bronchodilators, to help open the airways
  • Steroids, to help reduce inflammation
  • Diuretics, to help reduce excess fluid in the lungs
  • Antibiotics, to fight an infection
• Monitoring — Regular monitoring of breathing and heart rates
• Supplemental oxygen — To provide extra oxygen
• Surfactant replacement — A powder provided through an ET tube to treat respiratory distress syndrome

What is ECMO?

ECMO is an advanced therapy that offers support to your child’s heart and lungs when the lungs are unable to work hard enough on their own. Both our pediatric intensive care unit (PICU) and Level IV Neonatal Intensive Care Unit (NICU) are able to provide ECMO treatment for pediatric patients.

ECMO is typically only used as a pediatric treatment when the child has respiratory or cardiac failure and is not responding to traditional therapies. It is very important to us that we do not subject any child to a therapy that is unnecessary, which is why we have a strict patient selection process to ensure the necessity and benefits of therapy outweigh any risks.

Common conditions that may require pediatric ECMO treatment include:

• Congenital diaphragmatic hernia
• Congenital heart abnormalities
• Failure to wean from cardiopulmonary bypass
• Meconium aspiration syndrome
• Persistent pulmonary hypertension
• Pneumonia
• Respiratory failure
• Severe sepsis

Pediatric asthma treatment

Asthma is a chronic condition that creates breathing problems, mostly triggered by allergies. Pediatric asthma is the most common chronic childhood condition, affecting an estimated six million children in the U.S. Common asthma symptoms in children include heavy wheezing, tightening in the chest and difficulty breathing. The first step to managing pediatric asthma is to properly diagnose the condition.