Nunns Applied Respiratory Physiology 7th Pdf 82 UPDATED

Nunns Applied Respiratory Physiology 7th Pdf 82

The ability to screen for and detect lung disease in children is an important emerging topic that has been receiving increasing attention for almost a century [ 48 ]. In the mid 1970s, lower lung volumes and increased airway resistance and heterogeneity were used as predictors of respiratory disorders. However, many of these indices are easily affected by breathing pattern [ 49 ]. Thus, at present, chest radiographs (CXRs) remain the gold standard for screening, but as portable CXRs are expensive and generate ionizing radiation, they are not suitable for repeated assessment or daily use in day care [ 50 ].

Nasal continuous positive airway pressure (nCPAP) is the most commonly used method for respiratory support of infants and children with respiratory disease [ 51 ]. CPAP, first described in 1967, reduces the work of breathing by maintaining a relatively high inspiratory airway pressure and low transpulmonary pressure [ 52 ]. Nasal mask CPAP is the most widely used modality, and can be used on infants and small children because it provides a close approximation of the humidified and warmed nasal airway patency and pressures that are frequently encountered during sleep [ 53 ].

Spirometry is a standardized and reproducible screening technique used by occupational health and respiratory physicians to detect airway obstruction and assess ventilatory function [ 54 ]. While it provides valuable and reproducible information about airway resistance and lung volumes, it is not routinely used in children because of the discomfort caused to the child. The American Thoracic Society has established a workshop to develop a consensus statement to guide the use of spirometry as a standard diagnostic tool for airway disorders in pediatric patients [ 55 ].

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