Pulmonology

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The Department of Pulmonology at Sanjeevini Hospital, focuses on the diagnosis and management of disorders relating to the respiratory system, including the lungs, upper airways, thoracic cavity and chest wall. It is a one-stop centre for all lung related diseases.

The Pulmonology Department has medical professionals with a proven record of medical expertise in the field of Pulmonology and Bronchoscopy services.

They work in tandem with Critical Care Specialists and Allergists, to provide unparalleled expertise in the diagnosis and treatment of a range of difficult, unusual and complicated diseases of the respiratory system, such as Asthma, COPD (Smoking related lung diseases), Air Pollution related Lung Diseases, Infections (including Bacterial, Viral, Tuberculosis), Pleural Diseases (Including Pleural effusion/Pneumothorax/Empyema), Connective Tissue related lung diseases, Sarcoidosis and Sleep Apnoea (OSA/OHS/Obesity Related Lung Diseases).

Services we offer at Sanjeevini Hospital

Pulmonary Function Testing

Pulmonary function testing includes a broad range of tests that measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood.

The 3 main pulmonary function tests are spirometry, lung volume measurement, and diffusion capacity testing. Each of these tests provides different information about the health and functioning of the lungs and aids in the diagnosis and monitoring of respiratory diseases.

Spirometry

This is a test to assess how well the lungs exhale. You will be asked to breathe into a mouthpiece that is connected to an instrument called a spirometer. The spirometer measures the amount of air your lungs inhale and exhale over a specified time. You may be asked to breathe normally or to take a deep breath and expel the breath forcefully.

The amount of air you exhale during a forced breath (called the “forced expiratory volume,” or FEV) and the total amount of air you exhale during the test (called the “forced vital capacity,” or FVC) are important measures that your physician will use to help diagnose your condition and monitor your response to treatment.

Spirometry is especially useful for the evaluation of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD).

Lung volume measurement (plethysmography)

Plethysmography is a painless procedure that measures total lung capacity (how much air the lungs can hold). This type of test is especially helpful in evaluating restrictive lung diseases, in which a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of lung tissue or by abnormalities in the muscles or skeleton of the chest wall.

During plethysmography, you will sit in an airtight chamber, insert a breathing tube into your mouth, and inhale and exhale a measured volume of air. Then a shutter will close off the breathing tube, and you will be directed to breathe against the shutter’s resistance. This will cause your chest volume to expand, and this increase in chest volume will slightly reduce the volume in the airtight chamber. In turn, the pressure inside the box will change, and these changes will allow a determination of your total lung volume.

Diffusion capacity testing (DLCO)

To determine how efficiently your lungs transfer oxygen from the air into your bloodstream, your physician may order a diffusion capacity test (also called DLCO, which stands for “diffusing capacity of the lung for carbon monoxide”).

Diffusion capacity is measured when you breathe carbon monoxide for a very short period, often just 1 breath. When you exhale, the concentration of carbon monoxide is measured. The difference in the amount inhaled and the amount exhaled allows your physician to estimate how rapidly gas (oxygen) can travel from your lungs into your blood. Reduced diffusion capacity may indicate interstitial pulmonary disease and fibrosis.

To prepare for DLCO, avoid heavy meals for a few hours before the test, and don’t smoke for at least 4 hours prior to the test. Your physician may also give you more specific instructions.

Cardiopulmonary exercise testing (CPET)

Shortness of breath may be caused by impaired functioning of your lungs or your heart. State-of-the-art cardiopulmonary exercise testing (CPET) allows your physician to make that distinction on-site.

Your physician may order CPET for any number of reasons. For example, you may undergo CPET as a precaution before surgery. If you have heart or lung disease, CPET can also help your physician determine what level of exercise is appropriate for you and whether you need to use oxygen during exercise.

CPET measures how your lungs, heart and muscles react to exercise. Tests may be performed using a stationary bicycle or treadmill. As you exercise, measurements will be made of the amount of air that you breathe, how much oxygen you require, and how fast and efficiently your heart beats. Depending on the type of test, you may wear a face mask or mouthpiece and have electrodes applied to your chest to monitor the activity of your heart.

Anaerobic threshold test

The anaerobic threshold is the point at which your muscles are using more oxygen than your heart and lungs can deliver. When you reach this point, lactate starts to accumulate in your bloodstream. As with VO2 max, the higher your anaerobic threshold, the longer you are able to exercise. Measuring the anaerobic threshold involves taking blood samples (usually a pinprick to the thumb) during an exercise test while the intensity is progressively increased.

Bronchial provocation test

Bronchial provocation testing is used to evaluate how sensitive the airways in your lungs are. In the first part of this procedure, you will undergo pulmonary function tests (usually spirometry) to measure how much air you can breathe in and out and how quickly you can breathe. Then you will inhale a spray compound called methacholine, followed by a repeat of the pulmonary function tests. The before-and-after results will be compared to determine what changes there are in your breathing.

Radiography

Radiography (X-ray) of the chest is the most commonly performed diagnostic X-ray. A chest X-ray is helpful for the evaluation of the lungs, heart and chest wall and can be used to aid in the diagnosis or monitoring of emphysema, pneumonia, heart disease, lung cancer, and a number of other medical conditions.

Radiography is a painless procedure that takes just a few minutes. No special preparation is necessary.

Computed tomography (CT)

A computed tomography (CT) scan takes more detailed pictures than a typical X-ray. During a CT scan, cross-sectional images are generated of the thoracic structures in your body, including your lungs, heart, and the bones and tissues around these areas.

CT scanning is a painless and noninvasive procedure. Preparation for testing takes about 10 minutes and the CT scan takes 15 to 20 minutes.

Serologies for interstitial lung disease

Interstitial lung disease (ILD) is a general term that includes more than 130 chronic lung diseases. Underlying symptoms of these individual diseases are often similar, so your physician may order serology (blood) testing to help diagnose a specific lung disease.

Off-site services & procedures

The following services and procedures are conducted off-site to aid in the diagnosis and/or treatment of pulmonary conditions

Positron emission tomography (PET)

Positron emission tomography (PET) is a medical imaging technique. In PET, radioisotopes (compounds containing radioactive agents) are introduced into the body for the purpose of imaging, evaluating organ function, or locating disease or tumors. The radioisotopes are usually injected into the bloodstream.

Fiber-optic bronchoscopy

Fiber-optic bronchoscopy is a procedure in which a narrow, flexible tube with a tiny camera on the end is inserted through your nose or mouth into your lungs. This provides a view of your airways and also allows your physician to collect lung tissue specimens.

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