Respiratory Medicine, Allergy & Sleep Disorders
The department provides an active patient care service in the following areas: Clinical Pulmonology, Asthma-Allergy, Interventional Pulmonology, Pulmonary function testing and Sleep Disorders Unit.
Patient care is provided by a team of dedicated, highly trained respiratory physicians along with various clinical and support services. Additional support is provided by the, respiratory technicians, physiotherapists and patient counsellors.
Through clinical expertise and advanced technology, patients with respiratory diseases shall feel a renewed sense of confidence and ownership for their lives.
Consultants: Dr. Vikas Maurya MD, FNB (CCM), EDIC (UK), FCCP (USA), Dr. Puneet Khanna MD, IDCCM, EDIC-I, FCCP (USA)
- Advanced Respiratory Care with latest cutting edge technology
- Excellent Team: Respiratory physicians / experts trained in premier institution in India & abroad, with dedicated supporting staff
- Technology Partners: Olympus, Fujinon, Respironics, Phillips, Spiro Air (Morgan)
- Academics: Participates in national and international meetings to present papers and deliver lectures. Department conducts journal clubs, seminars, workshops and symposium.
Respiratory Care Services Offered:
- Interventional Pulmonology: Video-assisted Flexible Bronhcoscopy with facilities for TBLB/TBNA/Foreign body removal/ diagnostic and Therapeutic Interventions
- Bronchoscopic Electrocautery: Various instruments like Hot Forceps, Snare, Knife powered by cautery can be used for diagnosing and treating endobronchial (with in the airways) obstructive lesions like lung cancers, benign tumors, tracheo-bronchial stenosis and subglottic stenosis.
- Bronchoscopic Argon Plasma Coagulation (APC) is the application of heat produced by argon gas to coagulate nearby tissue without touching it to stop bleeding.
- Bronchoscopic Laser ablation is the application of laser beam to remove trachea-bronchial tumors, subglottic stenosis, trachea-bronchial stenosis management with high degree of precision.
- Tracheo-bronchial stenting is done for central or peripheral airway obstruction caused by cancers or benign diseases like tracheal, sub-glottic stenosis and trachea-oesophageal fistula (communication between wind pipe and food pipe). In this procedure a stent can be placed inside the airway to keep the airway open, which can be done easily through the bronchoscope with a considerable improvement in quality of life of non-surgical patients.
- Rigid Bronchoscopy for diagnostic and therapeutic purposes including foreign body removal, tumor removal and stenting in those patients not amenable for fibreoptic bronchoscopy
- Pleural Aspiration: This is a procedure wherein fluid accumulated outside the lungs in the chest cavity is taken out using a plastic cannula/needle for diagnosis of pleural diseases as well as therapeutic benefit when a large amount of fluid is causing respiratory embarrassment.
- Chest Tube/ Intercostal Drain: Various diseases involving the pleura (covering of lungs) cause accumulation of fluid/ pus/ air in the chest cavity. This compresses the lungs and has to be drained. A thin tube or a pigtail needs to be put in the chest cavity to drain this collection. This procedure can also be performed under ultrasound guidance when fluid is thick. Also the cavity can be sealed after the collection is drained to prevent re-accumulation in case of air of rapidly collecting fluid in cases like malignancy, liver and kidney diseases
- Medical Thoracoscopy / Pleuroscopy: There is potential space between the lungs and chest covered with thin film known as pleura, which some sometimes becomes a space for fluid, pus, blood and air collection. Medical thoracoscopy is a procedure to examine the pleural space (inside the chest) using an endoscope like device, called a thoracoscope, through a little hole (about 1-2 cm) in the chest. During the procedure, samples are taken for establishing diagnosis of pleural disorders in the form of biopsies from the pleura (the covering of lungs and chest wall) and fluid. The procedure is done under mild sedation (not general anaesthesia) and local anaesthesia. The total duration of the procedure is around 30-45 min. The same sitting can also be used therapeutically for pleurodesis in cases of effusions due to cancer
- Pulmonary Hypertension: Diagnosis and Management including right heart catheterization (PA Catheter)
- Pleural Procedures: Diagnostic & Therapeutic including pleural pigtail insertion and medical thoracoscopy
- Sleep Disorders Unit: Advanced Alice 4 Respironics [ Phillips] - We offer the most comprehensive range of inpatient and outpatient services for the evaluation, treatment and education of patients with sleep disorders. Sleep disorders include sleep disordered breathing, obstructive sleep apnoea, snoring, obesity hypoventilation syndrome, parasomnias, REM disorders, leg movements disorders and insomnia. We run a dedicated Snoring and sleep apnoea clinic for such patients during which sleep problems are dealt in compassionate manner including counseling of their disease and discussion of treatment options. Our sleep studies are very thorough with measurements of brain waves, respiratory pattern and leg movements for example and are fully attended by sleep technologists.
- Overnight Diagnostic Polysomnogram (PSG) or Sleep Study This is the most common type of sleep study, primarily used to diagnose sleep apnoea and parasomnia.
- Positive Airway Pressure (PAP) Titration Sleep Study with either Continuous Positive Airway Pressure (CPAP) or BiLevel Positive Airway Pressure (BIPAP) The sleep study is used to determine the necessary PAP pressure required to abolish the sleep apnoea and to determine effectiveness of PAP therapy.
- Multiple Sleep latency Tests to assess daytime sleepiness
- Maintenance of Wakefulness Testing to objectively determine ability to stay awake
- Non Invasive Ventilation: The purpose of ventilation is supporting the respiration.This can be achieved by an invasively by a ventilator connected to an endotracheal tube, going to the central airways from the mouth. Or this can be achieved non-invasively with positive pressure devices like the BiPAP, which are machines with motors generating airflow at high pressure delivered to the patients through a face mask. This is very useful for patients who are sufficiently initiating their breathing and need support. It can be very useful for certain patients for symptomatic relief and even avoiding a ventilator.
- Pulmonary Function Testing (PFTs): (Spirometry with diffusion and lung volume studies) - Pulmonary function tests are a group of tests that assess the functional status of the lungs and give us information about the likely cause of breathlessness. It measures how well we can inhale and exhale air and how well the gases such as oxygen move from the atmosphere into the body's circulation. PFT's are performed by our trained technicians in the PFT lab.
Pulmonary function tests are done to:
- Diagnose diseases such as asthma, bronchitis, ILD and COPD
- Find the cause of shortness of breath Check lung functions before surgery
- Measure progress in disease treatment Assess the effect of medication
- Measure whether exposure to chemicals at work affects lung function.
- Allergy: Comprehensive allergy diagnosis and management including Anti IgE therpy.
- Department routinely manages patients with Pneumonia, tuberculosis, respiratory failure (I & II), asthma, COPD, Sarcoidosis, ILD, Pleural effusion, pneumothorax, Pulmonary embolism, Pulmonary edema, ALI & ARDS, sleep disorders like obstructive sleep apnea, central apnea, lung Cancers and other pulmonary disorders.
- Bronchoscopic Cryotherapy is the application of extreme sub degree temperature probe to take superior endobronchial biopsies without bleeding, trachea-bronchial tumor removal and stenosis management
- Pulmonary Rehabilitation: This is an important component for patients with chronic respiratory diseases eg. Asthma, COPD, Interstitial Lung diseases and patients who are discharged from ICU with respiratory problems. These patients, despite maximal medical therapy, complain of bothering symptoms and unable to live with good quality of life. For this a comprehensive pulmonary rehabilitation package will be available. This package involves consultation with respiratory physician, lung function tests and 6 week physiotherapy schedule.
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