Over times, the study of the Respiratory Function has played a crucial role in diagnosis, in evaluating the results of therapy, and in monitoring the clinical evolution of patients with respiratory pathologies.

In Paediatrics, the development of techniques and strategies enabling respiratory functional studies throughout all paediatric age groups has proved to be extremely useful in the treatment of chronic obstructive pulmonary disease, represented by Asthma and other sibilant diseases, Cystic Fibrosis and Bronchiolitis Obliterans, and in other emerging diseases, such as bronchopulmonary dysplasia or in the pulmonary repercussion of diseases such as sickle cell anemia or neuromuscular and musculoskeletal diseases.

Initially, equipments, strategies, and recommendations employed in adults were adapted for use in children. The challenge was using them on infants and pre-school groups of children. The first required the development of specific resources and implementation under sedation. With regard to pre-school children, a no less demanding group, children are too old to be sedated and too young to be able to collaborate in the use of evaluation techniques of the respiratory function, which are particularly demanding. With this group, there was, thus, the need to develop resources and adapt recommendations to enable technical enforceability and correct interpretation. Both age groups have specificities that require technical specialization in order to offer a more appropriate answer to clinical issues.

A Paediatric Laboratory for Respiratory Function has to guarantee quality control that comply with agreed standards, and which involve environmental, hygiene, and safety control procedures. The ongoing specialization and training of Cardio-pneumologist Technicians working in these laboratories is crucial for maintained high quality standards.

The growing technical and clinical demand in paediatrics requires additional training of Cardio-pneumologist Technicians in distinct fields of their activity, so that, when dealing with so many different children on a daily basis, they can find answers efficiently using increasingly diverse new techniques and give clinical answers to extremely complex physiopathologies, which often are not entirely clear in paediatrics.

The challenge Cardio-pneumologist Technicians have to face at the Paediatric Laboratory for Respiratory Function has to do with their capacity to ensure that children between 3 years of age and adolescence cooperate in respiratory manoeuvres that are often complex to coordinate between the act of understanding and actual motor execution.

Currently, equipments have very complex software, and resources that foster children from distinct ages to collaborate, particularly when doing a spirometry test, such as games that facilitate children’s understanding of the manoeuvres and encourage their use for a longer period of time. This makes the atmosphere at the laboratory more relaxing, both for children and parents. A prior visit to the laboratory a day before the tests are made, playing and demonstrating respiratory manoeuvres in contexts that are distinct from those when the tests are actually carried out, help ensure that things go much more smoothly and successfully on the day of the actual test.

The Paediatric Laboratory for Respiratory Function has a permanent team of Cardio-pneumologist Technicians and a doctor who is responsible for the unit. They work together to attain excellence in the end results and to offer answers to the multidisciplinary teams from distinct medical and technical specialties, always trying to adjust equipments and their use to the aforementioned challenges.

The quest for new areas in paediatric respiratory function and continuous training are vital to maintain high quality standards which, in turn, will undoubtedly lead to improved health care given to patients.
Paediatric Laboratory for Respiratory Function Studies
Head Doctor: Dr. Teresa Bandeira.
Paediatric Unit – Director: Dr. Celeste Barreto.
Child and Family Department – Director: Professor Paulo M. Ramalho.
Author for purposes of correspondence: Ana Margarida Silva, Cardio-pneumologist Technician: anammsilva@gmail.com
Bibliography:

An Official American Thoracic Society/European Respiratory Society Statement: Pulmonary Function Testing in Preschool Children. Am J Respir Crit Care Med 2007; 175:1304–1345
SERIES ‘‘ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING’’, Edited by V. Brusasco, R. Crapo and G. Viegi; Number 2 in this Series : Standardisation of spirometry; Eur Respir J 2005; 26: 319–338
SERIES ‘‘ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING’’, Edited by V. Brusasco, R. Crapo and G. Viegi, Number 5 in this Series: Interpretative strategies for lung function tests; Eur Respir J 2005; 26: 948-968