Pulmonary and critical care

The Department of pulmonary Medicine is a group of faculty and trained nurses who provide comprehensive consultative evaluation and management for patients with pulmonary disease associated with cardiac disease, critically ill post cardiac surgery pulmonary complication patients or the workup of undiagnosed lung abnormalities. The division's overriding prevention, diagnosis and treatment of respiratory disease focusing on heart disease. We are working as Chronic Trombo Embolic Pulmonary Hypertension team (CTEPH) which consists of pulmonologist, echocardiologist, radiologist, peripheral vascular specialist, heart failure specialist and cardiac surgeon for making decision of treatment plan.  Different pulmonic labs include sleep lab, cardio pulmonary exercise test lab (CPET) and pulmonary function test lab.

Three faculty members are working in this ward which includes 3 separate laboratories: Sleep lab, CPET (Cardio Pulmonary Exercise Testing) lab, and pulmonary function test lab. 

• Sleep Laboratory:

In sleep laboratory 3 nurses and technicians who are trained in sleep medicine are working. The nurses and technicians provide the following services under supervision of faculty members:  

• Consultation and evaluation by specialists
• State-of-the-art 2 bed sleep laboratory
• Detailed evaluation and treatment of cardiac-related sleep disorder
• Management of NIV (Non Invasive Ventilation such as CPAP/BiPAP/IVAPS) adjustments difficulties
• Polysomnography(PSG), PAP titration

Respiratory physiology services contain:

• Preparatory pulmonary evaluation of high risk patients
• Pulmonary function test (PFT) such as Spirometry, Body box, Diffusing Lung capacity of carbon monoxide (DLCO). Cardiopulmonary exercise testing (CPET) laboratory provides comprehensive testing for patients with a variety of heart and lung conditions to determine whether the heart, lungs or skeletal muscles limit exercise capacity. The CPET laboratory is a national referral center for evaluating symptoms that arise during physical activity. It provides a wide variety of evaluations, ranging from resting measurements of metabolic rate to comprehensive exercise studies that rely on direct measurements of heart and lung performance to precisely define which organ system is limiting exercise capacity. The physicians evaluate cardiopulmonary disease particularly cardiac transplant and pulmonary surgery candidates for assessing prognosis of these patients. CPET performed under the direction of a physician, typically a respiratory or cardiac physician, with experience and training in exercise physiology, with knowledge of calibration, quality assurance, performance and interpretation of CPET. In addition, 12 trained nurses are working under direct supervision of pulmonologist or cardiologist.   

Five trained technicians under supervision of pulmonologist and anesthesiologist are working with Non Invasive Ventilation (NIV) and Invasive ventilation. Post cardiac surgery pulmonary complications such as difficult weaning or hypercapnia hypoxic failure are managed by expert physicians.

Respiration service:

Consultative services Evaluation and management of pulmonary disease in patients with heart failure, cardiovascular and pulmonary vascular disease  Preoperative pulmonary evaluation for high risk patients prior to cardiac surgeries such as CABG, Valvular surgery, Adult congenital cardiac surgery, Cardiac transplantation and Aorta surgery Evaluation and management of sleep disturbances including sleep apnea, insomnia and other sleep related issue

Diagnostic bronchoscopy services contain: Diagnostic flexible Bronchoscopy Broncho alveolar Lavage(BAL)  Endobronchial and Transbronchial lung biopsy Bronchoscopy in pulmonary and critically ill cardiac patient in ICU, CCU and bronchoscopy room.