Pediatric pulmonology is a specialty that encompasses the diagnosis, treatment, and follow-up of respiratory system diseases in children from infancy to adolescence. This field includes the diagnosis and treatment of many congenital or acquired diseases affecting the lungs, bronchi, and airways.
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What are Pediatric Pulmonology ?
Pediatric Pulmonology is a medical specialty that encompasses the diagnosis, treatment, and follow-up of respiratory system problems in children from infancy to adolescence.
In children, the respiratory system continues to develop from birth. The narrower airways, the immaturity of the immune system, and the inability of children to clearly express certain symptoms make this area a separate specialization.
This section covers the examination of conditions related to the lungs, bronchi, airways, and respiratory function. Symptoms such as persistent cough, wheezing, shortness of breath, frequent lower respiratory tract infections, chest tightness, and difficulty breathing fall within the scope of this section. Accurate identification of the underlying cause is particularly important in cases of recurrent or long-lasting symptoms.
What Diseases are Included in Pediatric Pulmonology?
The pediatric pulmonology department covers the evaluation of numerous diseases related to the respiratory system. These diseases can develop due to infections, allergic causes, congenital problems, or chronic respiratory tract problems. These diseases include:
Chronic cough
These are persistent or recurrent coughs. They can be caused by underlying conditions such as asthma, allergies, or hypersensitivity following an infection. A detailed evaluation is particularly important for coughs lasting longer than 3 weeks.
Respiratory tract infections
These are infections affecting the upper and lower respiratory tracts. Detailed evaluation may be necessary in cases of frequent recurrence. The immune system and environmental factors can influence the frequency of these infections.
Difficulty breathing
This is when a child has difficulty breathing or breathes rapidly. It may be a sign of airway narrowing or lung disease. This can be a significant finding that requires urgent evaluation.
Pneumonia
It is an infection of the lung tissue. It can manifest with fever, cough, and shortness of breath. Early diagnosis and the creation of an appropriate treatment plan positively affect the course of the disease.
Asthma
It is a chronic disease characterized by narrowing and sensitivity of the airways. It can cause wheezing, coughing, and shortness of breath. With appropriate monitoring and treatment, symptoms can be controlled.
Allergic rhinitis
It is a sensitivity of the nose and respiratory tract that develops due to allergens. Nasal congestion, sneezing, and coughing may occur. It can affect the lower respiratory tract and may be associated with asthma.
Cystic fibrosis
It is a genetically inherited chronic disease characterized by the accumulation of large amounts of mucus in the lungs. It can lead to frequent infections. Early diagnosis and regular follow-up are of great importance for quality of life.
Pulmonary hemosiderosis
It is a rare disease characterized by bleeding in the lungs. It can manifest as anemia and respiratory problems. It is a condition that requires expert follow-up and careful monitoring.
Sleep apnea
Sleep apnea is a condition where breathing stops briefly during sleep. It can be recognized by snoring and restless sleep. It can negatively affect a child's growth and development.
Snore
It occurs due to the narrowing of the airways during sleep. If it is persistent, it should be evaluated. It may be related to an underlying respiratory problem or adenoid enlargement.
Wheezing (rattling) breathing
It is a whistling sound heard during breathing. It is a significant indicator of airway narrowing. It can be a symptom of diseases such as asthma and bronchiolitis.
Tuberculosis
It is a contagious infectious disease affecting the lungs. It may manifest with a persistent cough and fatigue. Early diagnosis and treatment are important to prevent the spread of the disease.
Bronchitis
Bronchial inflammation is an inflammation of the bronchi. It manifests itself with cough and phlegm. It can occur in acute or chronic forms and may sometimes be associated with underlying diseases.
Chronic lung diseases
These are long-term diseases that affect lung function. They require regular monitoring. These diseases can directly impact a child's quality of life.
Lung problems seen in premature babies
Premature babies may experience respiratory problems because their lungs are not fully developed. These babies may require special monitoring and supportive treatment.
Bronchiolitis
Bronchiolitis is a common lower respiratory tract infection in infants. It can be accompanied by wheezing and rapid breathing. It is especially common in the first year of life and requires close monitoring.
Foreign body aspiration
Inhalation is the entry of food or small objects into the respiratory tract. It can lead to sudden coughing and shortness of breath. It is a serious condition that may require emergency intervention.
Bronchiectasis
It is a chronic disease caused by the permanent widening of the bronchi. It is characterized by frequent infections and phlegm. It requires long-term treatment and regular follow-up.
Interstitial lung diseases
This is a group of rare diseases that affect lung tissue. It can impair respiratory function. Early diagnosis is important in slowing the progression of the disease.
Primary ciliary dyskinesis
It is a genetic disease that disrupts the respiratory tract's cleansing mechanism. It manifests itself through frequent infections. It is a chronic condition requiring long-term monitoring.
Congenital lung diseases
It results from congenital structural abnormalities in the development of the lungs. It can present with symptoms early or late in life. In some cases, surgery or special monitoring may be necessary.
Aspiration pneumonia
It is a lung infection that develops as a result of food or liquids entering the respiratory tract. It is more common in children who have difficulty swallowing.
Respiratory problems due to reflux
Coughing and breathing problems can develop due to stomach contents refluxing upwards. It can be among the causes of chronic cough.
Exercise-induced breathing problems
It is shortness of breath and wheezing that occurs during physical activity. It may be related to airway sensitivity. It can affect a child's daily activities and sports performance.
What tests are performed in the Pediatric Pulmonology Department?
In the Pediatric Pulmonology Department, various tests can be performed to evaluate many respiratory system conditions such as cough, shortness of breath, wheezing, frequent lung infections, and asthma. These tests include:
Pulmonary function test (PFT)
Pulmonary function tests are performed to measure the lungs' capacity to take in and expel air. They are particularly used to assess whether there is airway narrowing in conditions such as asthma, chronic cough, and shortness of breath. The frequency of application depends on the child's age and compliance with the test.
Post-bronchodilator respiratory test
In this test, a standard respiratory measurement is taken first. Then, a medication that widens the airways is administered, and the test is repeated. The aim is to see if the airway narrowing improves with the medication and, in particular, to support the diagnosis of asthma.
Oxygen saturation measurement
A small device attached to the finger measures the oxygen level in the blood. It is a painless and quick method. It is frequently used to evaluate conditions such as shortness of breath, bronchiolitis, and pneumonia.
Blood gas analysis
An arterial or capillary blood sample is taken to measure oxygen and carbon dioxide levels in the blood. This is preferred in children with respiratory distress to assess the severity of the illness.
Lung Graphy (X-ray)
It is a primary imaging method used to evaluate lung infections, pneumonia, air trapping, and certain structural problems.
Thoracic ultrasound and computed tomography (CT)
It is used in situations requiring more detailed examination. It is particularly preferred in the evaluation of complicated infections, masses, or structural abnormalities.
Allergy tests
Allergy tests are used to evaluate allergic asthma and respiratory sensitivities. Skin prick tests or blood tests determine which allergens a child is sensitive to.
Blood tests
It is used to evaluate infections, immune system conditions, and allergic reactions. Tests such as complete blood count and inflammatory markers aid in diagnosis.
Sputum analysis
This test is performed to identify the infectious agent in children who can produce sputum. It is especially important in recurrent or resistant infections.
Sweat test
This is a specific test used to investigate certain hereditary diseases. The assessment is based on measuring the salt content in sweat.
Bronchoscopy
This is an advanced method that allows direct visualization of the airways. It can be used in cases of suspected foreign bodies, recurrent infections, or unexplained cough.
Bronchoalveolar lavage (BAL)
Bronchoalveolar lavage is a specialized examination method performed during bronchoscopy. In this procedure, sterile fluid is injected into a specific area of the lung and then withdrawn, and the resulting sample is examined in a laboratory.
Sleep test (polysomnography)
This test is performed to assess breathing problems during sleep. It is used to diagnose conditions such as snoring, sleep apnea, and nocturnal breathing pauses.
Exercise provocation test
It is used to evaluate shortness of breath and wheezing that occur during exercise. It is preferred in cases of suspected exercise-induced asthma.
Advanced immunological and genetic tests
It is used in cases of recurrent infections or suspected rare diseases. It provides detailed information about the immune system and genetic background.
What are the treatments used in Pediatric Pulmonology ?
Treatments for Pediatric Pulmonology vary depending on the type and severity of the disease, the child's age, and the extent to which the respiratory system is affected. The most commonly used treatment methods are as follows:
Drug treatment
It is used to relax the airways and reduce inflammation. Inhaler medications are frequently preferred for asthma and wheezing. Drug treatment is determined step-by-step according to the severity of the disease.
Antibiotic and antiviral treatments
Antibiotics are used for bacterial infections. Treatment can be administered orally or intravenously, depending on the severity of the illness.
Inhalation (medication via the respiratory tract) therapies
It allows medications to reach the lungs directly. These treatments, administered using nebulizers, inhalers, and spacer devices, are particularly preferred for asthma, bronchiolitis, and wheezing. They are fast-acting and have fewer side effects.
Oxygen and respiratory support
Children with shortness of breath are given oxygen support. Advanced respiratory support may be applied if necessary. In severely ill patients, intensive care support may be required. The aim of this treatment is to increase oxygen levels in the blood and reduce the burden on the respiratory muscles.
Respiratory physiotherapy
In some diseases, mucus accumulation in the lungs is a significant problem. In this case, respiratory physiotherapy is applied to clear the mucus. Postural drainage, chest physiotherapy, and special devices are used to support airway clearance. These methods are particularly important in chronic diseases such as cystic fibrosis and bronchiectasis.
Long-term follow-up and treatment
Treatment for cystic fibrosis, bronchiectasis, and chronic lung diseases is long-term and multifaceted. These patients require a combination of regular follow-up, airway management, inhaler therapies, and infection control.
