Applications and Future Directions of Infant Pulmonary Function Testing

During the past 20 years there has been enormous progress in the field of infant lung function testing, with respect to the range of tests and equipment now available, their applications in research and clinical studies, and the degree of national and international collaboration. The major role for lung function testing in infants remains firmly within the research arena,where it has been extensively used to examine the early determinants of airway function and to investigate underlying pathophysiology and response to therapeutic interventions in a variety of respiratory diseases during early life. During recent years there has been increasing emphasis on developing techniques that can be used in unsedated infants and for those requiring ventilatory support. Future strategies need to encompass a multicenter, multidisciplinary, collaborative approach, with results from infant pulmonary function tests being integrated with those from other disciplines, including imaging, genetics, inflammation and immunology. The aims of this chapter are to (1) provide an overview of the extent to which infant lung function tests have been used in clinical and epidemiological research in the past, (2) describe some of the recently developed techniques that may have increasing application in future years and (3) consider potential future contributions of infant pulmonary function testing in the management of respiratory disease during infancy.