The Pulmonology Department at Sunrise Hospital focuses on the diagnosis, treatment, and management of diseases and disorders related to the respiratory system. It deals with conditions affecting the lungs and airways, such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia, tuberculosis, lung cancer, and various respiratory infections.
The Pulmonology department provides advanced care for lung and respiratory diseases such as Bronchial Asthma, Chronic Obstructive Pulmonary Disease (COPD), Bronchitis, Lung Cancer, Acute and Chronic Respiratory Failure, Interstitial Lung Diseases, Pulmonary Hypertension, Pneumonia, Tuberculosis, Pleural Disease, Occupational Lung Diseases, Allergies, Advanced Lung Diseases, severe breathlessness, pneumothorax, massive hemoplysis, severe pneumonia and more.
We have facilities to admit critically ill patients in intensive care units, with advanced invasive and non invasive ventilator facilities and monitors. Pulmonology OPD services is available on all days. Department is supported by interventional radiology, Thoracic surgery and critical care team to ensure specialised services.
Our State-of-the-art Pulmonary Function Lab performs advanced studies such as Spirometry, Lung Volumes, Diffusion Capacity, Respiratory Drive, Airway Resistance and Chest Wall Compliance etc.
The department also performs sophisticated treatments such as Video Bronchoscopy, Thoracoscopy, Interventional Pulmonology and deliver care to patients with a variety of disorders.
Treatment options involve medication management, pulmonary rehabilitation, oxygen therapy, and in severe cases, surgical interventions such as Lung Transplant or Thoracic Surgery.
Interventional Pulmonology has revolutionized the field of Pulmonary Medicine by providing the most advanced minimally invasive procedures to diagnose and treat both malignant and non-malignant disorders of the lungs and airways and relieving symptoms that cause breathing discomfort.
Removing Endoscopic Bronchial Tumors: A Bronchoscope is a flexible tube with a camera at the end that is used to deliver laser and other cancer-killing technologies to tumors buried deep inside the lungs.
Placing fiducial markers: These tiny objects are placed in or near a tumor as a point of reference during stereotactic radiosurgery, a nonsurgical, precision-focused form of radiation therapy.
Inserting airway stents: A stent is inserted to secure an open airway and help patients breathe better.
Video-Assisted Thoracoscopic Surgery (VATS) is used to diagnose and treat symptoms in the chest, including lung cancer, with the aid of a thorascope—an endoscope with a small video camera—that transmits an image of the chest cavity onto a video monitor to help guide the procedure. VATS may be used to biopsy lung tissue and to perform complex procedures, such as lung resections (lobectomy).
Allergies and Asthma often occur together. The same substances that trigger your hay fever symptoms, such as pollen, dust mites and pet dander, may also cause asthma signs and symptoms. A chronic condition characterized by periodic wheezing, chest tightness, shortness of breath, and coughing. Asthma attacks occur when inflammation of the airways causes them to narrow, restricting airflow in and out of the lungs. The attacks can last minutes or days, and can be dangerous if the airflow becomes severely restricted. In some people, skin or food allergies can cause asthma symptoms. This is called allergic asthma or allergy-induced asthma.
Allergic asthma is a long-term condition, but also involves episodes, or attacks, when you’ll need quick relief.
Doctors may recommend both ongoing and short-term treatments to reduce symptoms. They’ll typically start by determining the severity of your symptoms before recommending specific treatments.
Determining Asthma Severity
There are four categories of Asthma. Each category is based on Asthma severity, which is measured by the frequency of your symptoms.
It’s important to track and monitor your symptoms to see if they’re improving. Your doctor may recommend using a peak flow meter to measure your lung function. This can help you determine if your asthma is getting worse, even if you don’t feel different.
Allergy Skin Prick Test
A skin prick test, also called a puncture or scratch test, checks for immediate allergic reactions to as many as 50 different substances at once. This test is usually done to identify allergies to pollen, mold, pet dander, dust mites and foods. In adults, the test is usually done on the forearm. Children may be tested on the upper back. Allergy skin tests aren't painful. This type of testing uses needles that barely penetrate the skin's surface. You won't bleed or feel more than mild, momentary discomfort.
Allergy Blood Test or Serum Test to identify the allergens
Allergy blood tests are used to find out if you have an allergy. One type of test called a total IgE test measures the overall number of IgE antibodies in your blood. Another type of allergy blood test called a specific IgE test measures the level of IgE antibodies in response to individual allergens.
Allergy Blood Test is done to with patients with symptoms like Stuffy or runny nose, Sneezing, Itchy, watery eyes, Hives (a rash with raised red patches), Diarrhea, Vomiting, Shortness of breath, Coughing and Wheezing.
If your total IgE levels antobodies are higher than normal, it likely means you have some kind of allergy. But it does not reveal what you are allergic to. A specific IgE antibody test will help identify your particular allergy. Your treatment plan will depend on the type and severity of your allergy. People at risk for anaphylactic shock, a severe allergic reaction that can cause death, need to take extra care to avoid the allergy-causing substance. They may need to carry an emergency epinephrine treatment with them at all times.
A bronchoscopy is a test that allows your doctor to examine your airways. Your doctor will thread an instrument called a bronchoscope through your nose or mouth and down your throat to reach your larynx, trachea, and the smaller airways of your lungs, which include the bronchi and bronchioles. The bronchoscope is made of a flexible fiber-optic material and has a light source and a camera on the end. Most bronchoscopes are compatible with color video, which helps your doctor document their findings. Bronchoscopy can be used to diagnose lung disease, tumor, chronic cough and infection. Sometimes the test is also sometimes used as a treatment tool. For example, a bronchoscopy can allow your doctor to deliver medication to your lungs or remove an object that’s caught in your airways, like a piece of food.
Bronchoscopy is usually done in a procedure room in a clinic or in a hospital operating room. The entire procedure, including prep and recovery time, typically takes about four hours. Bronchoscopy itself usually lasts about 30 to 60 minutes.
Interventional Pulmonology, a growing area of pulmonary medicine, focuses on using advanced, minimally invasive procedures to diagnose and manage a wide range of thoracic diseases. By using endoscopic techniques instead of surgery, this approach to care offers faster diagnosis, quicker recovery time, and less pain for our patients. Interventional Pulmonology Procedure offer diagnostic and treatment services for all major lung problems, including comprehensive evaluations of Abnormal chest X-rays, Cancer in the lung and chest, Chronic cough, Coughing up blood (hemoptysis), Liquid around the lungs (Pleural Effusion), Persistent respiratory failure requiring tracheostomy placement and management.
Other conditions treated include Airway stricture from benign and malignant causes, Amyloidosis, Carcinoid tumors, Compressed airways, Congenital airway stenosis, Endobronchial tumors, Fibrosing mediastinitis, Granulomatosis with polyangiitis, Lung cancer, Recurrent respiratory papillomatosis, Relapsing polychondritis, Tracheomalacia and Tuberculosis.
Interventional Pulmonology Procedures
Procedures for Interventional Pulmonolgy include:
For people with lung cancer or other cancers, interventional pulmonology biopsies can often accurately identify spread of cancer into lymph nodes. This can prevent unnecessary surgery or help determine the best choice for treatment.
Pulmonary Interventional radiology is a minimally invasive diagnosis and treatment option for patients suffering from illness or injury in their lungs.
As a safer, less painful alternative to surgery, interventional radiology uses advanced imaging to diagnose and treat a variety of lung conditions, including Bleeding, Blood clots, Fluid in the lungs, Hypoxia (trouble breathing), Lung cancer, Lung masses, Pulmonary embolism (when a blood clot breaks free and travels to the lungs)
Most Interventional Radiology procedures for lung disease require only a small incision the size of a pinhole, which reduces your pain and risk for complication. Compared to traditional surgery, interventional radiology also allows for a quicker recovery, as most procedures allow patients to be discharged the same day of their procedure or within 24 hours, getting them back to the life and activities they love faster.
Interventional Radiology for Lung Disease Treatments:
From diagnosing and treating lung cancer to reducing and removing life-threatening blood clots in or near the lungs, our interventional radiologists are experts at performing a full range of diagnostic and therapeutic procedures for lung disease.
A tunneled drainage catheter is used when patients have a recurrent accumulation of fluid surrounding the lungs called pleural fluid. A tunneled drainage catheter may also be used to drain fluid in the abdomen, called ascites. This minimally invasive procedure allows patients to drain fluid without much difficulty.
Invasive Mechanical Ventilation: Invasive mechanical ventilation can become a life saving intervention for your patients with respiratory and breathing difficulties. It involves an instrument penetrating via the mouth (such as an endotracheal tube), nose, or the skin (such as a tracheostomy tube through a stoma, a surgically-created hole in the windpipe) to serve as an artificial airway. The objectives of mechanical ventilation are primarily to provide oxygen, remove carbon dioxide, decrease the work of breathing and reverse life-threatening conditions such as hypoxemia, or insufficient oxygenation of arterial blood, and acute progressive respiratory acidosis, or build-up of carbon dioxide in the blood.
Invasive ventilation may be used during acute respiratory failure, weaning and for chronic respiratory failure when non-invasive ventilation is impossible to manage correctly. It can also be used as a means to maintain a patient’s airway during a surgical procedure, such as intubation done in the ICU.
Patients with a variety of disorders that may require intubation and invasive ventilation, including acute respiratory distress syndrome, pneumonia, asthma, chronic obstructive pulmonary disease, cardiogenic pulmonary edema, congestive heart failure, spinal cord injury, stroke, trauma, severe sepsis, shock , myasthenia gravis, Guillain-Barre syndrome, apnea with respiratory arrest, including cases from intoxication, drug overdose, or the effect of anesthetic and muscle relaxant drugs
Non Invasive Ventilation:
Non-invasive ventilation (NIV) is the delivery of oxygen (ventilation support) via a face mask and therefore eliminating the need of an endotracheal airway. NIV achieves comparative physiological benefits to conventional mechanical ventilation by reducing the work of breathing and improving gas exchange. The intervention is recognised as an effective treatment for respiratory failure in chronic obstructive pulmonary disease, cardiogenic pulmonary oedema and other respiratory conditions without complications such as respiratory muscle weakness, upper airway trauma, ventilator-associated pneumonia, and sinusitis.
Our smoking cessation clinic can be an easy and effective way to treat tobacco use and dependence. It gives intensive treatments to smokers motivated to quit, ensuring a higher success rate, but also treats "difficult" patients. The services offered at the clinic include individual intervention in the form of behavioral counseling, medication, and nicotine replacement therapy.
Pulmonary rehabilitation is a program of education and exercise that helps you manage your breathing problem, increase your stamina (energy) and decrease your breathlessness. The education part of the program teaches you to be “in charge” of your breathing instead of your breathing being in charge of you. You will learn how to pace your breathing with your activities, how to take your medicines and how to talk with your healthcare provider. The exercise sessions are supervised by a pulmonary rehabilitation staff that prepares an exercise program just for you. The exercises start at a level that you can handle (some people start exercising while sitting and others on a treadmill). The amount of time you exercise will be increased in time and the level of difficulty will change based on your ability. As your muscles get stronger, you will exercise longer with less breathlessness and be less tired.
Most programs meet two to three times a week and programs can last 4 to 12 weeks or more. Because the program staff are constantly monitoring your progress and increasing your exercises as you are able, attending every session is important.
Polysomnography (PSG) or Sleep Lab is a study or test done while you’re fully asleep. A doctor will observe you as you sleep, record data about your sleep patterns, and may identify any sleep disorders like Sleep Apnea. Doctor measures vital parameters like brain waves, skeletal muscle activity, blood oxygen levels, heart rate, breathing rate and eye movement. Sleep apnea is a treatable disorder in which a person stops breathing during sleep, often hundreds of times during the night. Sleep apnea has many different possible causes. In adults, the most common cause of obstructive sleep apnea is excess weight and obesity, which is associated with soft tissue of the mouth and throat. During sleep, when throat and tongue muscles are more relaxed, this soft tissue can cause the airway to become blocked.
Consequences of untreated sleep apnea include high blood pressure, uncontrolled diabetes and other cardiovascular diseases. People with untreated sleep apnea may also complain of falling asleep inappropriately, morning headaches, memory problems, feeling of depression, reflux, frequent urination in night and impotence.
Chronic Obstructive Pulmonary Disease (COPD) is a group of lung diseases involving airway inflammation, lung tissue damage, and limited airflow. Chronic bronchitis and emphysema are the most common forms of COPD. In COPD, the tubes that carry air in and out of the lungs are partly obstructed, making it difficult to breathe. Cigarette smoking is the most common cause of COPD, although long-term exposure to other lung irritants, such as dust, chemicals, and pollution, may also cause or contribute to COPD.
A condition that results from the damage and dilation (widening) of the large bronchial airways. The bronchial tubes become distended, forming small pockets where infection develops. A person may be born with bronchiectasis or may acquire it later in life, usually as a result of inhaling a foreign object or due to recurrent lung infections.
A form of Chronic Obstructive Pulmonary Disease. Chronic bronchitis may be diagnosed when the patient has had a cough with excessive mucus during most days of the month for at least 3 months
A form of Chronic Obstructive Pulmonary Disease. Emphysema involves damage to the air sacs (alveoli) in the lungs. The air sacs lose elasticity and are unable to completely deflate, which prevents them from filling with fresh air to adequately supply oxygen to the body.
Interstitial lung disease (ILD) is a broad term that includes a long list of chronic lung disorders. Though symptoms vary depending on the specific type of ILD, breathlessness and a dry cough are common to many of these disorders. ILD is usually a progressive condition that begins with inflammation of the deep lung tissues and eventually results in scarring of the alveoli (air sacs) and their supporting structures (the interstitium). This scarring, called fibrosis, causes the normally elastic tissues of the lungs to stiffen, which interferes with normal breathing and can make it difficult to perform routine activities without getting out of breath.
An illness that is caused by exposure to irritating or toxic substances in the work environment. These substances may trigger acute or chronic respiratory problems with a severe single exposure or more commonly due to prolonged or repeated exposure.
Rheumatoid arthritis is an inflammatory disease that primarily affects the joints and surrounding tissues. However, it can also damage the lungs, causing inflammation of the lining of the lungs (pleuritis), accumulation of fluid around the lungs (pleural effusion), rheumatoid nodules (small lumps) in the lungs, and scarring of the lungs (pulmonary fibrosis).
Inflammation of the airways, usually caused by infection. It may be short-lived (acute) or chronic. Symptoms include a cough that produces mucus, wheezing, shortness of breath, fatigue, and mild fever. Acute bronchitis often follows a viral respiratory infection, such as a cold or flu. A secondary bacterial infection is also common.
Progressive scarring of lung tissue caused by exposure to microscopic fibers of asbestos. Asbestosis is most common in construction and industrial workers.
A chronic condition involving obstruction of the small airways that results in severely impaired lung function. The most common cause is dust from hemp, flax and/or cotton processing.
An allergic reaction caused by exposure to an organism that grows on hay, straw, grains, and other organic materials found on farms. Farmer’s lung can occur in an acute form, with flu-like symptoms developing 4 to 8 hours after exposure to moldy dust. It can also occur as a chronic disease that develops gradually and causes progressive damage to the lungs. Farmer’s lung can be controlled, but it cannot be cured.
An acute or chronic inflammation of the airways caused by exposure to an inhaled allergen, such as mold, bacteria, or fungi. The air sacs of the lungs become inflamed and may develop fibrous scar tissue that interferes with normal functioning and causes shortness of breath and coughing.
A lung disease caused by exposure to silica dust in mines, foundries, blasting operations, and stone, clay and glass manufacturing. Scar tissue forms in the lungs and substantially increases the risk of tuberculosis.
Thickening and scarring of the lungs, specifically of the interstitium (the area in and around the small blood vessels and air sacs where the exchange of oxygen and carbon dioxide takes place). This leads to a decline in the ability of the lungs to extract oxygen from the air.
An inflammatory disease that is characterized by granulomas (tiny lumps of immune cells) that can grow and clump together in organs, affecting how these organs function. Sarcoidosis usually starts in the lungs or lymph nodes, but it may eventually affect other organs. Besides the lungs and lymph nodes, the most commonly affected organs are the skin, eyes, and liver. The course of the disease varies greatly, from a mild condition that gradually gets better on its own to a severe and progressive disease that causes permanent damage to organs. There is no known cause and no known way to prevent sarcoidosis.