Tertiary Referrals

• Unexplained respiratory symptoms e.g. noisy breathing, cough,
• breathlessness, chest pain, exercise intolerance.
• Difficult to treat asthma / severe asthma
• Severe infant wheezing
• Cystic fibrosis
• Recurrent pneumonia
• Empyema
• Obstructive sleep apnoea and other sleep disturbances
• Tuberculosis (TB)
• Congenital thoracic malformations
• Ventilator-dependent children

• Unexplained respiratory symptoms e.g. noisy breathing, cough,
• breathlessness, chest pain, exercise intolerance
• Infant wheezing, Asthma, Chronic cough
• Recurrent chest infections
• Few children might need a holistic feeding assessment by our partner multi disciplinary team comprising of dietitians and speech and language therapists. Please find more information available at https://www.kidsfeedingteam.co.uk/

Simple tests that can be carried out in clinics–

• Chest x-ray
• Lung function (children aged 6 and over)
• Allergy tests

More complex investigations are carried out at Royal Manchester Children’s Hospital and may involve an overnight stay.

• Chest CT scan
• Lung function testing including exercise tests, bronchodilator responsiveness
• Sweat test (for Cystic Fibrosis)
• Flexible bronchoscopy including airway brushings, bronchoalveolar lavage.
• Sleep studies – level 1 (oximetry), level 2 (polysomnography - includes respiratory movement, nasal airflow, and video)
• Nasal ciliary brushings and nasal nitric oxide (for primary ciliary dyskinesia)
• Blood testing for allergy and immune function, CF genotyping.