Pulmonology

 The Department of Pulmonary provides diagnosis of and treatment for patients with illnesses that affect the lungs, breathing and sleep disorders. The department is well-equipped with robust technology to provide a comprehensive & holistic care both for the outpatients and patients admitted to the hospital, including the ICUs.

Pulmonologists have expertise in evaluating, diagnosing and treating various health conditions including chronic obstructive pulmonary disease (COPD), asthma, lung cancer, interstitial lung disease (ILD), sarcoidosis, pulmonary hypertension, pulmonary embolism, sleep disorders, lung infections like pneumonia, tuberculosis (TB), acute and chronic respiratory failure.

This department also has an allergy clinic to manage and prevent allergies of different types. In addition, a collaborative and multidisciplinary team of physicians, technicians, patient educators, nurses offer compassionate care in addition to family education and other supportive services.

Comprehensive care is provided for patients with:

  • Asthma
  • Allergic rhinitis & sinusitis
  • Congenital abnormalities of the lungs
  • COPD (Chronic bronchitis & Emphysema)
  • Cystic fibrosis, Bronchiectasis
  • Home mechanical ventilation (NIV/NIPPV) & oxygen therapy
  • Interstitial lung diseases (IPF, Hypersensitivity Pneumonitis)
  • Sarcoidosis
  • Pneumonia, TB, Fungal infections of the lung
  • Lung cancer
  • Pulmonary embolism, Pulmonary hypertension
  • Pleural effusions, Pneumothorax, Empyema
  • Obstructive sleep Apnoea & Sleep disordered breathing (SDB)
  • Respiratory failure due to various causes
  • Thoracic skeletal deformities, Motor Neurone disease with diaphragm & intercostal muscle weakness
  • Complex multi-system disorders involving the Lungs

Facilities

  • Well-trained Pulmonology team
  • Routine procedures like chest drains (both Seldinger & regular drains), Pleural aspirations
  • Bronchoscopy (Both Adult & Paediatric): bronchoscopic washings, lavage and biopsy including transbronchial lung biopsy (TBLB)
  • Bronchoscopy with Narrow Band Imaging technology (Bronchoscopic option to detect early cancer)
  • Rigid bronchoscopy
  • Laser therapy of airways, Airway foreign body removal
  • Airway stenting
  • Endobronchial Ultrasound (EBUS)
  • Flexi-Rigid Thoracoscopy
  • Comprehensive PFT Lab (Spirometry, DLCO, muscle strength assessment
  • Sleep disorders clinic & NIV clinic (CPAPs & Bilevel PAP)
  • Smoking cessation Clinic
  • TB clinic
  • Lung cancer clinic
  • ILD Clinic
  • Thoracic Surgery back-up
  • Excellent Radiology team who are extremely competent in performing all the image-guided procedures (Ultrasound/CT guided)
  • 24×7 cath lab that can cater to emergencies like Bronchial artery embolisation.
  • Comprehensive sleep lab (PSG, Split-night studies for titration, in-house sleep technologist for manual scoring of the sleep studies)
  • Intensive care services for management of critically-ill
  • Training programmes for Pulmonary and Critical Care specialists
  • Pulmonary Rehab Programme

Interventional Pulmonology

Our Interventional Pulmonology team provide diagnostic and therapeutic interventions by employing video-assisted flexible bronchoscopy, rigid bronchoscopy, thoracoscopy & EBUS guided procedures. They deal with complications of tracheostomy and intubation (tracheal & bronchial stenosis), relapsing polychondritis, tracheo-bronchomalacia, lung nodules, lung masses & cancers, haemoptysis (blood in sputum), pleural effusions (fluid in the pleural spaces surrounding the lungs), enlarged lymph nodes between the lungs (hilar & mediastinal lymphadenopathy)

Electrocautery & APC via Bronchoscopy

Lesions like benign cancers, sub-glottic stenosis, lung cancers are the obstructive lesions (tracheobronchial stenosis) diagnosed and treated by employing electric current to open up the airways and to stop bleeding. APC technique or Bronchoscopic Argon Plasma Coagulation is employed to stop bleeding with the help of heat produced by argon gas to coagulate nearby lung tissues.

Bronchoscopic Laser technique

Laser beam is employed in bronchoscopy for tumour debulking, to remove obstructions (stenosis) that causes shortness of breath with high precision.

Balloon Dilation for Tracheal and Bronchial Stenosis

In this technique, small balloons are passed through the bronchoscope to dilate bronchial tubes. This is quite similar to the way in which cardiologists perform angioplasty.

Tracheo-bronchial Stenting

Airway obstructions are usually caused by tracheal or bronchial stenosis (either benign or cancerous). To remove such obstructions, the airways are kept opened with the help of a stent placed inside the airway, with the help of either rigid/ flexible videobronchoscope.

Rigid Bronchoscopy

For patients who are not candidates for fibre-optic bronchoscopy, rigid bronchoscopy is the preferred diagnostic and therapeutic technique for tumour and foreign body removal, stenting and sometimes to deal with significant bleeding.

Endobronchial Ultrasound (EBUS)

A bronchoscope with an ultrasound probe at the tip is used by the pulmonologist to detect abnormalities and perform biopsies in the inaccessible and abnormal areas of the lung (mediastinal & hilar lymph glands). This technique is precise, accurate and thus minimizes the risk of puncturing blood vessels inside the lungs, as it is done under guidance of ultrasound.

Intercostal Drain / Chest Tube

Lungs are covered by 2 layers of pleura. Fluids, air, blood, pus can accumulate in this potential space due various diseases, causing collapse of the lung. To re-expand the lungs by removing the fluid/air, a small tube is inserted into this cavity. The procedure can also be performed under ultrasound guidance.

Thoracoscopy / Pleuroscopy

In this procedure, a thoracoscope (camera) is used to examine the space surrounding the lungs. The camera is inserted via a small hole (1-2 cm) under local anaesthesia and a careful examination of the space is done and biopsies are taken under direct vision as opposed to the blind biopsies done previously.

Autofluorescence Bronchoscopy

This technique is an advanced way to detect pre-cancerous lesions of the lung. In auto-fluorescence bronchoscopy, a bronchoscope with special light (NBI) is passed through the bronchial tubes to identify any abnormalities, which are quite difficult to be seen by standard bronchoscopy.

PleurX Catheter placement
In this procedure, a pig-tail catheter is placed in the pleural space when fluid continues to re-accumulate, in patients with malignant pleural effusions.

Sleep Disorders

Obstructive sleep apnea, snoring, insomnia, restless leg syndrome, obesity hypoventilation syndrome, breathing difficulty during sleep, parasomnias, are different types of issues related to sleep.

Non Invasive Ventilation

Ventilation of the lungs can be achieved non-invasively (without having to put tubes into the throat) with the help of machines and motors that generate airflow at high pressure, which is then passed to the patients by means of face masks. This technique is useful for patients with breathing difficulties and sleep problems. 

Pulmonary Function Testing (PFT)

The various pulmonary function tests are used to assess the breathing capacity/lung capacity of individuals. A team of experienced and trained technicians perform PFTs in the PFT lab. They are useful in the diagnosis of conditions like Asthma, ILD, and COPD. They are also used in the assessment of the lung capacity prior to major surgery and air-travel. In addition, it also helps in analysing the effectiveness of medications.

Pulmonary Rehabilitation

Patients who suffer from chronic / end-stage lung diseases, require a comprehensive / holistic  care to improve their quality of life. This includes assessments by pulmonologists, physiotherapists, psychiatrists (to enable cope with the disease) along with the support of the families. This programme is aimed at gaining the confidence of the patient.