By Stephanie D. Davis, Ernst Eber, Anastassios C. Koumbourlis
Over the prior two decades, diagnostic assessments for pediatric pulmonologists have revolutionized care of kids bothered with breathing problems. those assessments were used not to simply assist in prognosis, but additionally within the administration and remedy of those young children. Bronchoscopic, imaging and physiologic advances have enhanced medical care of those young children and feature been used as end result measures in learn trials. Diagnostic assessments in Pediatric Pulmonology: purposes and Interpretation describes a few of the diagnostic modalities (especially the more moderen ones) which are on hand for the overview of pediatric respiration issues. It additionally presents an figuring out of the benefits and barriers of every try out in order that the clinician could decide on the main applicable ones. An the world over popular crew of authors describe how most sensible to interpret the most important findings in various checks in addition to the prospective pitfalls in fallacious interpretation. This quantity makes a speciality of the most diagnostic modalities utilized in the review of pediatric sufferers with breathing problems and provides up to date details at the benefits and boundaries of every try out for a number of stipulations encountered within the perform of pediatric pulmonology. medical application of those checks is usually highlighted. This important source is easily suited for practising clinicians, together with pediatric pulmonologists, pediatricians and first care practitioners, in addition to trainees, breathing therapists and scientific researchers.
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Extra resources for Diagnostic Tests in Pediatric Pulmonology: Applications and Interpretation
The limitations discussed above in regards to TBB for the diagnosis of parenchymal disease, predominantly in ILD, led to recent successful introduction of transbronchial lung biopsy by flexible cryo-probe. The technique allows acquisition of large biopsy samples of lung parenchyma that exceed the size and quality of samples obtained by forceps biopsy . No pediatric reports are yet available, but in an adult study comparing historical controls to transbronchial cryo-biopsy in lung transplantation patients, no significant bleeding or pneumothorax occurred following transbronchial cryo-biopsy.
Metallic stents. The potential for metallic stent erosion through the thin bronchial wall is a subject of discussion, but with scant documentation. Wells et al.  described two patients with associated heart disease and stenting of the left main stem bronchus (LMSB). Both patients presented with ruptured pseudoaneurysms adjacent to the stented bronchus; this complication was likely compounded by adjacent bronchial collateral vessels in patients with cyanotic heart disease. Stents might also erode into surrounding structures, with possible exsanguinating hemorrhage from bronchovascular fistulae .
Pepsin in bronchoalveolar lavage fluid: a specific and sensitive method of diagnosing gastro-oesophageal reflux-related pulmonary aspiration. J Pediatr Surg. 2006;41:289–93. 16. Knauer-Fischer S, Ratjen F. Lipid-laden macrophages in bronchoalveolar lavage fluid as a marker for pulmonary aspiration. Pediatr Pulmonol. 1999;27:419–22. 17. Ding Y, Simpson PM, Schellhase DE, Tryka AF, Ding L, Parham DM. Limited reliability of lipid-laden macrophage index restricts its use as a test for pulmonary aspiration: comparison with a simple semiquantitative assay.
Diagnostic Tests in Pediatric Pulmonology: Applications and Interpretation by Stephanie D. Davis, Ernst Eber, Anastassios C. Koumbourlis