In the Department of Pulmonology, we treat patients with diseases of the lungs. We offer extensive diagnostics in respiratory medicine. Besides lung function, including spiroergometry, the department is furnished with modern pneumonological endoscopy equipment.
We conduct a bronchoscopy (endoscopy of the airways) to examine and treat your respiratory tract and lungs. The diagnostic bronchoscopy is usually performed in local anesthesia and sedation with a thin flexible tube called a flexible bronchoscope. The therapeutic bronchoscopy is usually done in general anesthesia using a rigid bronchoscope. In addition to the bronchoscopic diagnostic examinations, one of the focal points of our department is interventional bronchoscopic treatment. During the examination, experienced bronchoscopy nurses will also accompany you. During interventions in general anesthesia, an anesthesiologist is present during the course of the procedure.
During diagnostic bronchoscopy examinations, we observe and assess your respiratory tract and remove samples, if necessary. Here, we use washing (bronchial lavage and bronchoalveolar lavage) as well as the removal of tissue samples (biopsy) with pliers, brushes, or needles. Changes that are located outside of the airways are punctured and targeted using ultrasound with special endoscopes (endobronchial ultrasound, EBUS). By changes and pulmonary lesions, we utilize x-ray (fluoroscopy) and ultrasound (EBUS miniprobe) for localization during biopsy.
During therapeutic bronchoscopy examinations, we perform interventions on your ill respiratory tract or lungs. The intervention is used for the reduction or elimination of dyspnea or the therapy of other serious conditions. In doing so, secretion or debris can be removed, narrowed airways dilated (balloon bronchoplasty) or splinted (stent implantation), tumor tissue removed, and bleeding stopped. Another specialty of our department is the interventional treatment of patients with pulmonary emphysema, in which we perform an endoscopic lung volume reduction (ELVR) by implantation of valves or coils.
In our function area, we offer all the usual examination methods of respiratory medicine. The following examination techniques are possible:
- Capillary blood gas analysis
- The ear lobe is rubbed with an ointment that promotes circulation and then blood is drawn with a capillary tube. This enables the determination of gas distribution in the blood and thus the severity of lung and heart diseases.
- The patient breathes through a mouthpiece according to instructions from a nurse. The recorded curves allow a calculation of lung volume and airway flow velocity. In this way the respiratory function can be checked.
- Body plethysmography
- Similar to spirometry, body plethysmography allows the analysis of respiratory function. The patient sits in an airtight glass chamber and breathes on instruction from a mouthpiece. The measurement provides results on the airway resistance, flow capacity, respiratory volumes, and abnormal hyperinflation of the lung.
- After results from spirometry or body plethysmography indicate narrowing of the respiratory tract, it can be tested whether this restriction persists or can be influenced by medication. To do this the patient receives a further bronchus-dilating spray for inhalation and the test is repeated. If there is a significant improvement, this could be an indication for asthma.
- Metacholine challenge test
- A metacholine challenge test involves irritation of the bronchial tubes with the inhalable drug metacholine. The test is used to clarify symptoms such as persistent cough that lasts many weeks or shortness of breath. If the inhalation of metacholine leads to a narrowing of the respiratory tract as measured in the spirometry, this indicates a hypersensitive bronchial system.
- Measuring the diffusion capacity
- Determining the diffusion capacity allows an assessment of oxygen uptake from the bronchi to the blood in the lungs. The patient breathes in a safe quantity of carbon monoxide from a balloon. From the decrease in carbon monoxide concentration, the oxygen uptake can be calculated.
- Measurement of muscle strength and compliance
- With this investigation, the elasticity of the lungs and respiratory muscle strength can be measured. The test is useful for patients with myopathies or neuromuscular disorders
- Spiroergometry with non-invasive cardiac output measurement, if necessary
- For spiroergometry, the patient needs to ride on an ergometer bike. During the exam, a mask worn by the patient enables the measurement of respiratory gases. At the same time, an ECG and blood pressure are monitored. The test serves to clarify shortness of breath, limited performance and can be used as a progress evaluation for heart and lung diseases. Furthermore, it can detect whether heart or lung disease is the cause for limitation in performance.
- Six-minute walk test
- In the six-minute walk test, the patient is instructed to walk on a level surface as quickly as possible over a period of 6 minutes. The test serves mainly as a progress assessment for patients with lung diseases.
- Sleep apnea screening/ Sleep laboratory LINK to the sleep laboratory
- During sleep apnea screening, the patient sleeps with a small, mobile device that continually records respiratory flow, oxygen supply, snoring, heartbeat, and breathing motion. This allows the diagnosis of breathing disorders during sleep, e.g. obstructive sleep apnea syndrome. In case of abnormal findings, further investigation is required in the sleep laboratory.
- Capillary blood gas analysis