March 4th 2019
PLAC – Pulmonology FAQs
A pulmonologist is a doctor who specializes in diagnosing and treating respiratory illnesses. A pediatric pulmonologist cares for infants, children and adolescents who have breathing problems.
Asthma is a chronic respiratory disease commonly identified during childhood. It affects the airways within the lungs and occurs from:
- Increased Mucous Production
Symptoms occur when airways are irritated from asthma triggers. Triggers can include upper respiratory infections, allergies and exercise. More than 14 million school days are missed annually due to asthma. Asthma can be controlled in the majority of children if properly treated. It is important to visit your doctor if your child has been diagnosed with asthma and they cough or wheeze regularly.
Cystic fibrosis is a life-threatening genetic disease that causes mucus to build up and clog some of the organs in the body, particularly the lungs and pancreas. When mucus clogs the lungs, it can make breathing very difficult. The thick mucus also causes bacteria (or germs) to get stuck in the airways, which causes inflammation (or swelling) and infections that lead to lung damage.
Mucus also can block the digestive tract and pancreas. The mucus stops digestive enzymes from getting to the intestines. The body needs these enzymes to break down food, which provides important nutrients to help people grow and stay healthy. People with cystic fibrosis often need to replace these enzymes with medicine they take with their meals and snacks, which helps them digest food and get proper nutrition.
Bronchiolitis is the leading cause of hospitalization for infants in the United States with over 100,000 admissions annually. It is usually seen from December through April. It is a viral infection that begins as an upper-respiratory infection and then progresses to involve the lower small airways of the lung, known as the bronchioles. These tiny airways become swollen and filled with mucus, making it very difficult to breathe. Small infants and babies are more susceptible to severe disease secondary to the very small diameter of these airways.
The most common cause of bronchiolitis is respiratory synctial virus, or RSV. This is a common wintertime virus in the Northern Hemisphere. Other viruses such as influenza (flu), rhinovirus, and human metapneumovirus (HMPV) can also cause bronchiolitis.
Infants with a history of prematurity, congenital disorders (problems they are born with) such as congenital heart or lung disease, or live in homes with smokers are higher risk of severe bronchiolitis.
Apnea of prematurity is defined as cessation of breathing by a premature infant that lasts for more than 15 seconds and/or is accompanied by decreased oxygen saturation or a fall in heart their heart rate (bradycardia). Apnea is traditionally classified as obstructive, central, or mixed. Obstructive apnea may occur when the infant’s neck is hyperflexed or hyperextended. It may also occur due to low pharyngeal muscle tone or to inflammation of the soft tissues, which can block the flow of air though the pharynx and vocal cords. Central apnea occurs when there is a lack of respiratory effort. This may result from central nervous system immaturity, from irritation due to reflux or from the effects of medications or respiratory illnesses. Many episodes of apnea of prematurity may start as either obstructive or central, but then involve elements of both, becoming mixed in nature.
Chronic lung disease (CLD), also known as bronchopulmonary dysplasia, occurs when a newborn’s lungs have been injured. Damaged tissue inside the baby’s lungs becomes inflamed and may break down, causing scarring. This scarring can make it difficult for a newborn to breathe, in which case the baby will need oxygen therapy. In the past, the condition was thought to only affect premature babies with a breathing problem called respiratory distress syndrome, who were treated with oxygen through a ventilator. However, with the development of new therapies and improved ventilation techniques, CLD rarely affects larger premature babies. It’s now seen primarily in very premature newborns, both those who have been treated for respiratory distress syndrome and those who have not. Most babies with CLD survive, and many outgrow their lung problems. While they have CLD, it’s important for them to receive good nutrition to prevent problems with growth and development and complications of the condition.
Treatment for chronic lung disease depends on the severity of the condition. Therapy involves vaccinations to ward off infections, and oxygen to help babies breathe normally while their lungs grow and develop. Some babies may need a medicine, called a diuretic, which makes them pass more urine to remove extra fluid from around their lungs. Some babies may not need oxygen therapy by the time they go home, but others will need continued treatment after they’ve left the hospital. Many of these babies may require other inhaled medications on a chronic basis to reduce airway tone (bronchodilators) and inflammation (inhaled steroids).
At The Pediatric Lung and Allergy Center we use special equipment and trained personnel to measure your child’s breathing. These tests are called Pulmonary Function Tests (PFT’s) or spirometry. Your child’s test results are compared to predicted values based on your child’s height, race, age and sex similar to a growth curve.
These tests are easy and fun for our patients and consist primarily of taking a big breath and blowing out as fast as possible. Interactive ‘breathing games’ encourage our patients to give their best effort. The equipment then measures the breath and airflow comparing it to predicted values and any previous test to monitor progress.
Our physicians and their assistants are specifically trained to interpret these tests to determine the presence and progress of lung disease such as asthma. These breathing tests are recognized by the National Heart, Lung and Blood Institute as an important tool in the diagnosis and management of lung disease.