The vision of Respiratory Medicine Department is excellence in evidence-based care for all patients. The department has well qualified and dedicated Pulmonologists who strive to provide care of the highest standard.

The aim of the department is to provide compassionate care for a successful patient outcome. We also update our knowledge on latest research and available care to meet the growing needs of people.

The department provides comprehensive consultation, evaluation and treatment of the whole range of respiratory diseases. In addition to daily outpatient and inpatient services, the department conducts weekly speciality clinics for patients suffering from Asthma, Chronic Obstructive Pulmonary Diseases (COPD), Smoking Cessation and Allergy Clinics. This has led to a steady flow of patients to the hospital’s general and critical care wards (Respiratory ICU).

The Pulmonology department is equipped with a DOTS laboratory for the National Tuberculosis Elimination Programme (NTEP). It offers an isolation ward and DOTS Plus services to cure patients with Multi-Drug Resistant Tuberculosis (MDR-TB) and prevent its propagation. The unit is collaborating with the district TB health society and is functioning effectively with free supply of drugs given under the national programme.

The unit also does Allergen tests in collaboration with the Department of Dermatology and Department of ENT. Besides, Physiotherapy and Pulmonary rehabilitation is available for patients with chronic respiratory diseases like COPD and ILD.

The department has a research laboratory to conduct therapeutic trials. It has adult bronchoscopes and video bronchoscopes that are often used to teach postgraduate students.

Services Available Currently

• DOTS Laboratory for RNTCP (TB) services
• Dots plus services/ isolation ward for multi Drug Resistant TB patients
• Adult bronchoscope & Video bronchoscope to teach Postgraduates
• Thoracoscopy (semirigid) available to diagnose pleural diseases
• DLCO and Spirometry available
• MIP/MEP with Spirometry to exclude Neuro muscular disorders
• Sleep lab (portable) to diagnose sleep Apnoea disorders
• Allergen test done in collaboration with Dermatology department
• Research laboratory available for therapeutic trials
• Health education utilizing audio visual aids for Asthma and COPD patient is done on weekly basis in outpatient department
• Physiotherapy and pulmonary rehabilitation is taught for patients with chronic respiratory diseases on need basis
• Speciality clinics – COPD clinic/ Asthma clinic and Rheumato Pulmonology clinic on weekly basis

Features

• Asthma care programme
• Asthma and COPD Clinics with an Amrita Asthma Education Programme conducted fortnightly
• COPD Rehabilitation Clinic
• Allergy and Immunotherapy Clinic
• Smoking Cessation Clinic including counselling and pharmacotherapy intervention services
• Sleep disorder clinic
• Fibreoptic Video Bronchoscopy Clinic
• Pleural Clinic (Ultrasound chest and ultrasound-guided procedures at bedside as well as in OPD)
• ILD Clinic (Multi dimensional team management of ILD)
• Non invasive ventilator

Outpatient Services

Patient Education and Rehabilitation

A number of outpatient programs are available at the Department of Respiratory Medicine for patients suffering from advanced emphysema, asthma and chronic bronchitis. These programs include pulmonary rehabilitation, transtracheal oxygen, and nutritional support. The Smoking Cessation Program is under the direction of physicians and therapists experienced in the treatment of nicotine dependence.

Asthma Self-Management Program

Asthma patients who are treated on an outpatient basis are periodically scheduled for group presentations about asthma, including different types of the disease, common symptom, frequently used medicines, inhalers, and accessory equipments. Patients are shown how to use peak-flow machines and are taught self-management techniques for their use at home.

COPD Rehabilitation Services

Services include education about COPD and physical therapy. Patients can benefit from pulmonary rehabilitation if they have emphysema, asthma, or chronic bronchitis. A team of healthcare professionals with various specialities staff the Pulmonary Rehabilitation Program. The team consists of a pulmonary physician, a clinical nurse specialist, an exercise physiologist, a respiratory therapist, a dietician, and a social worker.

Smoking Cessation Clinic

Services offered include an initial consultation with a Pulmonologist regarding smoking habits. Patient education is provided, and the motivation to stop smoking is discussed. Pharmaceutical intervention may be offered where appropriate counselling is also offered to patients attending the clinic and on a follow up basis as needed.

Inpatient Services

The Department of Respiratory Medicine works in coordination with the Department of Cardiovascular and Thoracic Surgery and the Department of Neurosciences to ensure the highest quality of care for patients with pulmonary problems.

Diagnostic Tests Offered

Pulmonary Function Tests

Pulmonary Function Tests (PFTs) are useful in diagnosing various lung disorders. They also measure the degree of impairment due to the disease. The progression of a disease and the effectiveness of treatments can be carefully observed with regularly scheduled testing. Pulmonary Function Tests are also used frequently to assess preoperative risk and are done supervised by chief respiratory technician.

Advanced Pulmonary Function Tests

• Body box and diffusion capacity of lung
• Lung volume estimation
• Cardiopulmonary exercise testing
• Six-minute walk test

Flexible Video Bronchoscopies

Flexible Video Bronchoscopic investigation and treatment is provided as an outpatient bronchoscopy service. Bronchoscopies are useful in the investigation of problems such as coughing or an abnormal chest x-ray and are performed under local anaesthetic. A modern endoscopy suite with fluoroscopy is available for outpatient and inpatient bronchoscopies. A fibreoptic bronchoscopy system with video and photographic capability is used for performing bronchoscopies which helps in the complete visual assessment of air passages and in making an accurate diagnosis of infection, cancerous changes, and also in obtaining biological samples for pathological examinations.

Evaluation of Breathing Disorders and Chronic Respiratory Ailments

Advanced PFT Lab

We are very proud to say that we have state-of-the-art “Pulmonary Function Test” Lab in our department. We are equipped with performing basic spirometry to highest level complex pulmonary function test like lung volume, diffusion capacity and cardio-pulmonary exercise test.

Evaluation and Treatment of Sleep Disorders

We provide level 1-4 sleep studies as per the need of the patient. We have collaboration with other specialities like ENT/dental and neurology for comprehensive care for obstructive sleep apnea patients.

Procedures Done

• Spirometry (PFT)
• Diffusion capacity of carbon monoxide (DLCO)
• Lung volume (FRC, TLC)
• Cardio pulmonary exercise testing
• Six-minute walk test (6 MWT)
• ABG
• Allergen sensitivity tests
• Fine needle aspiration biopsy (FNAB)
• Pleural aspiration and biopsy
• Fibreoptic video bronchoscopy and FOB guided BAL, bronchial biopsy, TBNA and TBLB
• Medical Thoracoscopy
• Intercostal tube drainage and pigtail drainage
• Pleurodesis
• Polysomnography (Sleep study)
• Oxygen titration
• CPAP titration
• Pulmonary rehabilitation for COPD and ILD patients

Future plans

• To expand department with emphasis on interventional Pulmonology
• Collaboration with oncology department to start services for Lung cancer patients
• To improvise on critical care areas
• To expand research related activities
• To start speciality clinic for specific disorders of Respiratory Medicine
• To improve patient care, give health education and improve counseling skills
• Innovative teaching methods for Under graduate and Post graduate students using simulation lab