Specialized Testing

Infant Pulmonary Function Testing

The spirometry and plethysmography test measures flows and lung volumes. Both tests require a level of cooperation that is usually achievable in children 6 years and older.  However, new techniques and equipment are available to perform these tests in infants and toddlers. The testing is done under sedation to ensure passive cooperation. Testing takes approximately 90–120 minutes, but can give results with similar accuracy as in older children.

Learn more about the Infant Pulmonary Function Testing Patient Procedure.

*Pulmonary Consultation required.

Bronchial Provocation Testing

In many cases, a patient is diagnosed with asthma using his or her symptoms and response to medication. Usually, lung function is normal when the patient is asymptomatic. A provocation test is designed to induce asthma symptoms, using either an inhaled chemical, such as methacholine, or other stimuli, such as cold air and exercise. The stimulus is usually provided in increasing amounts, with spirometry performed after each step.  If a significant decrease in lung function occurs, the patient is then given a bronchodilator medicine. This testing frequently lasts up to 2 hours and requires the patient to perform spirometry consistently and repeatedly.

High Altitude Simulation Testing

Commercial airplanes are usually pressurized to approximately 8,000 feet while flying at 30,000 feet. The barometric pressure results in a lower amount of oxygen and can cause decreased oxygen levels in the blood. Patients with lung disease may require additional oxygen while flying. The High Altitude Simulation Test can determine the amount of extra oxygen needed during air travel. The patient breathes a gas mixture with a decreased amount of oxygen to simulate the amount that would be present while flying. Additional oxygen is administered during the test to determine the amount necessary to maintain normal blood oxygen levels. Testing takes approximately one hour.

Distribution of Ventilation

Some diseases that affect very small airways are difficult to detect. Multiple breath inert gas washout (MBW) testing measures the functional residual capacity (FRC) and the efficiency with which gas mixes in the lungs. MBW testing consists of 2 phases, a wash-in and a wash-out phase. During the wash-in phase of testing, the patient breathes a gas mixture containing a tracer gas until the inhaled and exhaled gas concentrations are equal. During the washout phase, the tracer gas is allowed to dispense out of the lungs.

This testing requires cooperation that is usually achievable in children 6 years and older. Testing takes approximately 30 minutes.

Impulse Oscillometry

Oscillometry, like spirometry, tests for blockages in the breathing tubes. However, unlike spirometry, this test can be conducted using regular breathing and does not require a forceful exhalation. This test requires a lower level of cooperation than spiromety, but provides different information.