Frequently Asked Questions | Pediatric Pulmonology | UC Davis Children's Hospital

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A Polysomnogram, also called a sleep study, is an overnight diagnostic test performed in the sleep laboratory. This type of sleep study provides our board-certified sleep specialist physicians with the information he or she needs to diagnose various sleep disorders. The test is done by securing sensors with water-soluble paste and hypo-allergenic tape on your head, face, chest, one finger and both legs. There is no pain involved in the placing of these sensors and the sleep technologist will explain what will be done before and while sensors are being placed on you.

During the night you will be observed by our sleep technologist for signs of various sleep disorders by monitoring brain waves, body movements, sleep position, electrocardiogram (EKG), blood oxygen levels and respiration. Depending on the results of the study, we will be able to determine if your child has conditions such as obstructive sleep apnea, insomnia, night terrors or periodic limb movement disorder.

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Flexible bronchoscopy is a procedure under sedation or anesthesia that uses a fiberoptic and/or digital camera to visualize your chlid’s airways, including inside the lungs. The camera may be inserted via the nose, mouth, or a temporary breathing tube. Bronchoscopy can be performed to help arrive at a diagnosis (such as testing for infection) but may also help in the removal of severe mucous burdens or in giving medication to a localized portion of the lung.

If one of our pediatric pulmonary physicians recommends a flexible bronchoscopy, you can typically expect a pre-procedure consultation with an anesthesiology team member. Patients should typically have no food nor drink on the night before the procedure. On the morning of the procedure, you will meet the Children’s Surgery Center team that will care for your child in the operating room (OR). Some patients can leave the hospital that same day while others will require monitoring in the hospital overnight.

Because pediatric bronchoscopy is performed under sedation or anesthesia, children typically do not feel discomfort and do not remember the procedure. Cough, fever, and sore throat are possible side effects and typically resolve in 24-48 hours. In certain critical care circumstances, flexible bronchoscopy may be performed at a child’s bedside under sedation in our intensive care units (ICUs) in consultation with our pediatric pulmonary team.

Pulmonary function testing (PFT) is a group of tests which measure how well the lungs are working. The tests are non-invasive methods in which the patient demonstrates how fast and hard they can blow to assess the function of the lungs. This helps physicians in understanding and evaluating different types of lung disorders. Lung function tests are also used to assess how lungs are responding to certain treatments.

There are several different types of pulmonary function tests that can be completed, including:

• Spirometry (offered in outpatient pulmonary clinic)
• Fraction exhaled nitric oxide (FENO) test (offered in outpatient pulmonary clinic)
• Lung Volumes Diffusion Capacity (offered in main hospital)
• Exercise test (offered in the main hospital)

Asthma is a chronic lung condition in which the airways become inflamed, swollen and may produce more mucus. This can result in symptoms such as coughing, wheezing (whistling sound) or shortness of breath. Asthma can affect both children and adults, but often symptoms start in early childhood.

The cause of asthma is not always clear. We do know there is likely a genetic component to the disease, however, there is no specific gene that we know of that causes asthma. There is also a known association of asthma with food allergies, eczema, and allergic rhinitis. Asthma symptoms can worsen due to certain “triggers” which often include infection, allergies, and irritants (smoking, chemical fumes/odors, perfumes).

The diagnosis asthma is based on symptoms, lung function testing (if old enough to perform them), blood work, and response to inhaler therapy. While there is no cure for asthma, it can be well managed by taking asthma medications and avoiding triggers which worsen symptoms.

Cystic fibrosis is a recessive genetic disorder that affects the lungs and digestive system. It is characterized by viscous secretions and its most serious symptom is difficulty breathing due to frequent lung infections.

Cystic fibrosis impairs production of a protein called the cystic fibrosis transmembrane conductance regulator (CFTR), a protein that normally regulates the balance between salt and water in cell membranes. As a result, the coating of fluid and mucus within the lungs and other organs becomes much thicker and less pliable than it should be. This thickened mucus mass traps bacteria, making children who have contracted cystic fibrosis particularly susceptible to repeated lung infections. Over time, repeated infections can diminish lung capacity, leading to a reduced life span.

Although no cure for cystic fibrosis currently exists, ongoing medical therapy can significantly reduce respiratory difficulties and improve digestion.

BPD stands for “bronchopulmonary dysplasia” and most commonly affects babies and young children who are born prematurely. Rarely, it also affects babies born at term (at/near their due dates). It is most often understood as a developmental condition of the lungs where immature lung growth causes some infants and toddlers to be dependent on supplemental oxygen even after leaving the hospital. In severe cases, long-term ventilation may be required though this is much less common.

The lungs develop rapidly in the first two to five years of life, and with appropriate nutrition and growth, many children with BPD can wean from their treatments in the first several months to few years after birth under the supervision of a pediatric pulmonologist. Severe BPD may affect a child’s risk of abnormal lung function as an adult, so feel free to ask our care team about the long-term prognosis for your child.

RSV stands for “respiratory syncytial virus” and is one of the most common, severe respiratory infections affecting infants and toddlers in the first years of life. It is contagious and spreads via contact with respiratory droplets. It often causes bronchiolitis, a type of infectious lung inflammation, and it is a common cause of admission to the hospital in young children, particularly children born prematurely.

While RSV bronchiolitis can be severe, a substantial portion of children with RSV have mild symptoms not requiring hospitalization. Children with severe RSV bronchiolitis have a somewhat increased risk of asthma in the future.

Congenital lung malformations (CLMs) are an abnormality in the development of the lung tissue and/or vessels that occurs when a baby’s lungs are developing in the womb. Congenital lung malformations are usually diagnosed on prenatal ultrasound, however, sometimes they can be diagnosed after birth with imaging of the lung.

The symptoms of malformations can vary in severity depending on the type and size of the malformation. Some children may require surgery to remove the abnormal region of the lung, especially if it is causing breathing problem such as fast breathing, low oxygen saturation or poor weight gain. A pulmonologist and pediatric surgeon will often work together to form the best management plan for the child.

A tracheostomy is a small, long-term breathing tube inserted surgically through the skin of the neck and into the windpipe (trachea) below the voice box (vocal cords). Tracheostomies are inserted by otolaryngologists (ear/nose/throat surgeons) in the operating room when the care team and family agree that it would bring a patient comfort, wellbeing, and quality of life.

Some conditions require a tracheostomy only, but the tube can also be used to support breathing by delivering long-term ventilation via the tracheostomy tube. If a patient’s health improves long-term, the tube may be removed.

Ventilators are complex medical devices regulated by the FDA (Food and Drug Administration) and designed to support a patient’s breathing by delivering air flow, pressure, and supplemental oxygen when needed. Ventilators help deliver oxygen to the blood via the lungs and help clear carbon dioxide (CO2). They can be used to deliver help with breathing via masks on the face (for part-time use), via an endotracheal breathing tube, or via a tracheostomy tube surgically inserted via the neck.

While ventilators are most often used during critical illness in an intensive care unit (ICU) in the hospital, portable ventilators can be used for long-term ventilation at home in a portion of patients.

Apnea of prematurity is a genetic, sleep-related respiratory disorder in which premature infants stop breathing for 15 to 20 seconds during sleep. Such lapses in premature infants can be caused either by airway obstructions or by incomplete development of the medulla – the portion of the brain that controls breathing.

Apnea of prematurity caused by inadequate nerve impulses may respond to massaging the infant’s body. If necessary, it can be treated by artificially stimulating the breathing response with medications. Following treatment in the hospital, home monitoring equipment can alert parents about possible recurrences. The condition may subside and disappear as an infant matures.

Bronchitis is a condition in which the bronchi – the air ducts leading to the lungs – become inflamed due to viral infection. Bronchitis produces coughing, shortness of breath and wheezing. Normally, bronchitis disappears as the infection completes its course.

Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. Viruses, bacteria, and fungi can all cause pneumonia. In the United States, common causes of viral pneumonia are influenza viruses, respiratory syncytial virus (RSV) and SARS-CoV-2 (the virus that causes COVID-19).

Vaccines can help prevent infection by some of the bacteria and viruses that can cause pneumonia.