How does your clinic do ped lung function?

[Aboveallislove]

Could folks share what their kids clinics do re lung function?
what age do they start?
could you list the fev etc they test if you have a copy to check?
do they do with a bronchial dial arbor? How? Ie two puff or neb how ans how long between redoing?
do they use a booth thing for annual and what does that do?
as much detailed as you can provide would be great! Thanks

 

[Ratatosk]

I refused to have ds participate in the booth pfts at our local cf clinic. It's shared with everyone and we weren't so sure how well things were sanitized. And by shared with everyone it includes ppl with copd and other respiratory diseases. A few years ago the hospital almost lost their accreditation due to issues with infection control. Ds does pfts at his cf clinic in the city. It's in a room, hooked to a computer, no booth. No bronchodilators.

And we've only run into another cf patient once in the 11 years we've gone and that was walking past them in the hall. Ds is just now mastering how to do pfts, it's taken a few years

 

[2005CFmom]

My daughter wasn't diagnosed until she was 8, so I don't know at what age they normally start. She does her PFT's in the exam room. The RT has a handheld device and the test is given without bronchodilators. She normally does 3 blows, but if there was a problem with one she may have to do an extra. There are 4 categories listed on her test (each category is broken down into Test and %predicted) so there are 8 values given. FVC [L], FEV1 [L], FEV1/FVC ratio, and FEF25-75 [L?S]. Hope that helps and is not too confusing.

 

[Aboveallislove]

Thanks so much both. We were planning on declining booth for same reason and was curious how many centers do. Any more details would be great from more folks!

 

[Dhobs]

My daughter had her first one as an infant inside an enclosed bed with a vest that inflated and deflated to push the air through her lungs. It was not an experience I was willing to go through again because they have to be asleep for it and boy did she fight those drugs! She didn't have another until she was maybe 4 and those were just practice to get her good at doing them.

If they are done at clinic, there is a room that we go to with a machine in it but no booth. There IS a booth in another room but even when we go to that room, the booth isn't used. I am very lucky that she goes to clinic at a hospital that I can trust to follow sterilization rules and I would be ok with the booth if they needed to test that way.

 

[Aboveallislove]

Thanks Dhobs. We had done 2 of the infant ones and then decided it wasn't worth it. The booth thing apparently tests total lung capacity and residual volume (called plethysmography). And I'm really curious as to how many CF Centers that is considered "standard of care" to do that annually. I also wonder whether that information really adds to the decision process versus what a lung function test would do and cultures, etc.

 

[Ratatosk]

Until last December ds was unable to master his pfts. And his doctor indicated he's got teenage patients who still haven't figured it out, so he wasn't too concerned with ds' results, especially since his culture results were fine and he'd had a lung scan that showed his lungs were fine (for a person wcf).

 

[Aboveallislove]

Thanks Ratatosk! That really helps because I was fearing that the "booth" was giving extra needed info, and we are on the extremely cautious side and I value your balanced approach so it helps to know you had concerns too (albeit b/c of center). And also great to know re culture and the lung tests. We got a home spirometer for practicing and got one "D" grade one this am for first attempt and I was thinking I can't imagine how they can get anything out of a 5 year old of value since that was after 10 attempts when machine cut us off!

 

[ryry11]

I started PFTs when I was 6, and the first year or year and a half or so was pretty up and down, even though we know my lungs were stellar. I would have 130% FEV1 on one blow and 50% on another because I just didn't have technique. It took me a long time to get the technique down (into my early teens). I wouldn't stress too much about it. When I could start doing consistent tests (probably age 10), we would do 3, an inhaler, and then 3 more. It was always at a computer, not in a booth- I don't think I've ever used a booth. We learned that I did PFTs better when I was more awake (so no 7:30 PFTs).

 

[ponytails]

My daughter is 6 almost 7 and has been doing pfts since she was 4 1/2. We do them in a booth. I sterilize it myself. It still makes me anxious though. It is in a booth where the breathing apparatus is callabrated with a computer. We do pfts every 3 months. She seems to have a very solid grasp of the technique. Her pfts have been the exact same percent (127% of predicted) for the last 6 months. I don't have an iphone so I can't post a picture but they test the following: fvc, , fev, fev/fvc, fef (25-75), vmax 80%, vmax 70%, vmax 60%, frc%, rv%, tlc%, rv/tlc, sbn2, and Co2.