Portfolio of services

Specialized assistance in external consultation

The Unit's consultation is equipped with all the necessary devices for a correct and accurate assessment of the child: spirometry, pulmonary resistance measurement (RINT) and muscle strength study (PIM and PEM), sweat test (Wescor / macroduct), exhaled nitric oxide measurement and shared plethysmograph with Adult Pneumology, and pediatric and neonatal fibrobronchoscopy, etc.

It includes diagnostic and therapeutic care activities, as well as health promotion, health education and disease prevention, which include:

• Initial assessment of the patient.
• Joint evaluation with referral hospitals for patients with low prevalence and high complexity pathologies.
• Indication and conduct of diagnostic examinations and procedures.
• Indication of evaluation for other pediatric specialties and joint assessment of the pathology in a multidisciplinary team when necessary.
• Teamwork in conjunction with specialized nursing.
• Indication, carrying out and monitoring of the therapeutic treatments or procedures that the patient needs.
• Information on discharge from diagnosis and procedures and care necessary for the correct follow-up of the patient to primary care.

Specialized hospital care by day

It encompasses the diagnostic activities of patients requiring short-stay admission under medical supervision for treatment and / or performing diagnostic tests, including:

• Practice of fibrobronchoscopy (preparation and post-fibrobronchoscopy control)
• Immunodeficiency treatments with intravenous and subcutaneous gammaglobulins.
• Food provocation and reintroduction tests.
• Drug testing, desensitization.
• Short treatments for asthma attacks, initiation of antibiotic guidelines for chronic patients.
• Omalizumab treatments in patients with severe asthma.
• Immunotherapy Unit.

Specialized care for admitted patients

It covers the medical care, diagnosis and treatment of patients on hospitalization, including: consultation of patients of other specialties, newborns or general pediatrics who require specialized medical care.

• Indication and diagnosis, treatment and monitoring of patients admitted to the specialty.
• Indication and follow-up of patients in intensive care if necessary.
• Specific education on the diseases and the different treatments of patients who need it.
• Information on discharge from the care process with specific instructions for the correct monitoring and treatment of the patient.

See Apnea and Apparently Lethal Episodes in the Infant (ALTE)

This is a consultation where infants with apnea episodes (transient respiratory stops longer than 20 seconds in length) are treated, or those who have suffered what is technically called "Apparently Lethal Episode." These are children who are in a state of respiratory arrest, whatever the cause, but who have been able to be resuscitated, either by their parents or by healthcare staff.

Children with obstructive airway obstruction constantly or only during sleep. The latter are also studied in the Sleep Unit using polysomnography.

Others have or have had one or more episodes of shortness of breath without an apparent cause.

There is a complete protocol for the study of these cases, as well as outpatient follow-up and various treatments that are discussed with the admitted child and continue with the patient at home, depending on the cause of the problem.

Pathologies attended to

Cystic fibrosis: A reference unit for the center of Catalonia

• Neonatal Screening for Cystic Fibrosis.
• Multidisciplinary team (educating nurse / physiotherapist, pulmonologist, gastroenterologist, endocrinologist, nutritionist, psychologist, clinical laboratory)
• Continued care of the patient with cystic fibrosis with uncontrolled disease (intercurrent process ...)
• Training and knowledge for home treatments
• Learning sessions for respiratory physiotherapy, drug nebulization, ...
• Drug dispensing by the Hospital Pharmacy

Asthma

• Day hospital for short treatments for exacerbated chronic patients.
• Follow-up of patients with moderate and severe asthma.
• Asthma Health Education.
• Respiratory physiotherapy where required.
• Treatment of severe asthma. Administration of Omalizumab.

Congenital pulmonary malformations / prenatal diagnosis

• Radiological support for the diagnosis:
• Prenatal ultrasound
• Prenatal MRI
• Surgery team qualified for congenital malformative surgery.
• Prenatal Diagnostic Commission. Ethics Commission.
• Prenatal counseling visit and follow-up.
• Pediatric postoperative ICU support

Pathology of the airway / endobronchial foreign body

• Collaboration with ORL, anesthesia and pediatric surgery.
• Diagnostic / therapeutic fibrobronchoscopy.
• Rigid bronchoscopy
• Conventional radiology
• Other specific imaging methods.

Respiratory complications of neuromuscular diseases. Non-invasive mechanical ventilation

• Reference center in the monitoring of patients with need for home mechanical ventilation.
• Diagnosis, treatment and support of neuromuscular diseases of varying degrees of severity.
• The patients are treated in a multidisciplinary way by visiting the same day by the various specialist doctors (neuropediatist, pulmonologist, ORL, orthopedist)
• Nurse / Physiotherapist controlling ventilation

Chronic pulmonary pathology - Oxygen therapy

• Monitoring and control of chronic pulmonary pathologies (Bronchopulmonary dysplasia, cystic fibrosis, primary ciliary dyskinesia ...)
• Interstitial pneumonia.
• Control of oxygen therapy.
• Prevention strategies.
• Administration of palivizumab to the indicated patients.

Infectious pulmonary pathology (pulmonary tuberculosis, complications of pneumonia, bronchiectasis, ...)

• Diagnosis, monitoring and treatment of pulmonary tuberculosis. Statement required. Study and treatment of endobronchial TB.
• Complications of low airway infections: necrotizing pneumonia, pulmonary abscess, pleural empyema. Collaboration with pediatric surgery and interventional radiology. Follow-up and discharge with report to the pediatrician.
• Bronchiolitis obliterating, Bronchiectasis. Monitoring and management in collaboration with Physiotherapy.

Obstructive airway pathology. SAOS / Pulse Oximetry-Polysomnography. CPAP / BIPAP

• Study of congenital stridor, noisy breathing, hoarse cough, ... in collaboration with radiology, fibrobrocoscopy, cardiology (malaria, stenosis, malformations, vascular rings)
• SAOS, etiological study. Polisomnography unit. Home or hospital pulse oximetry.
• Specific treatments and ventilation support and monitoring.

Primary and secondary immunodeficiencies

• Diagnosis, treatment and monitoring. Collaboration with the Immunology Unit of the Vall d'Hebron Hospital.
• Administration of intravenous and subcutaneous gammaglobulins.

Rhinoconjunctivitis, sinusitis, otitis

Multidisciplinary clinical assessment.

Food allergy, cow's milk protein allergy, atopic dermatitis, hives, angioedema, anaphylaxis

• Practice Test of food provocation and reintroduction.
• Diagnosis, monitoring, treatment and desensitization.
• Multidisciplinary clinical assessment.

Insect poison allergy

Hymenoptera poison immunotherapy.

Drug allergy

• Diagnostic skin diagnostic tests.
• Oral provocation test.

Special immunotherapies

• Immunotherapy in children under 5 years.
• Rapid immunotherapy, rush and cluster in the Immunotherapy Unit.