The Pulmonary Diagnostic and Wellness Center at Bryn Mawr Hospital is an
outpatient diagnostic and rehabilitation program offered for people with
lung and respiratory disorders. The center is a fully equipped and
staffed site that includes a pulmonary function laboratory for diagnosis
and a comprehensive pulmonary rehabilitation program.
Rehabilitation program participants meet three times a week for six
weeks. Each two-hour session uses education and exercise to help reduce
respiratory symptoms and optimize the ability to carry out daily
activities. Respiratory therapists and other healthcare professionals,
under the direction of a pulmonologist, establish appropriate
individualized programs to help patients work toward their goals. An
extended maintenance program is also offered to patients completing the
initial program. Programs are available on both an inpatient and
The center offers the latest in lung function tests (LFTs) and related
This is usually the first lung function test performed on a patient. An
instrument called a spirometer is used to screen for pulmonary function
abnormalities by measuring basic lung functions in a number of different
ways. Common measurements taken include: forced vital capacity (FVC),
forced expiratory volume (FEV), forced expiratory volume after one
second (FEV1), FEV1 as a percentage of FEV, forced expiratory flow (FEF)
and peak expiratory flow (PEF).
Spirometry Reversibility Testing
This test measures reversibility of obstruction in obstructive pulmonary
diseases, such as asthma. Spirometry measurements (see above) are taken
before and after the use of a medication. The "pre" and "post"
measurements help determine the reversibility (treatability) of the
Lung Volume Testing
Lung volume testing assesses hyperinflation or restrictive disease.
Measurements include: functional residual capacity (FRC), which is the
amount of air in the lungs after a normal exhaled breath; total lung
capacity (TLC), or the amount of air in the lungs after inhaling as
deeply as possible; and residual volume (RV), or the amount of air left
in the lungs after exhaling as completely as possible. Lung volume
measurements are taken using a technique known as plethysmography; the
nitrogen washout method may also be used.
Lung Diffusion Testing
Lung diffusion tests measure the diffusing capacity of the lung for
carbon monoxide (DLCO), i.e., the efficiency of gas transfer from the
air sacs of the lungs into pulmonary circulation. They are used to
assess diseases affecting pulmonary vascular bed, such as interstitial
lung disease and emphysema.
Maximum Voluntary Ventilation
This test assesses respiratory muscle strength by measuring the greatest
amount of air the patient can breathe in and out during one minute.
Maximum Inspiratory and Expiratory Pressures
This test also assesses respiratory muscle strength and is helpful in
diagnosing neuromuscular disease.
Bronchial Provocation Testing
Also called the methacholine challenge, bronchial provocation testing
diagnoses atypical asthma. Special spirograms are performed after
inhalation of increasing concentrations of methacholine.
Cardiopulmonary Stress Testing
The patient undergoes maximum exercise with a breath-by-breath analysis
of expired gases and an electrocardiogram (ECG). Arterial blood gases
(ABGs) may be drawn at rest and during exercise. Parameters reported
include: maximal oxygen uptake, anaerobic threshold, oxygen pulse
and dead-space-to-tidal-volume ratio. This test is used to determine the
cause of dyspnea in patients for whom other tests have proven
inconclusive. Recent pulmonary function tests (PFTs) and a pulmonary
physician are prerequisites.
High-Altitude Simulation Testing
Used for questionable patients prior to air travel or travel to a higher
altitude, this test measures patient's heart rhythm via ECG, oxygen
saturation and heart rate while breathing air with oxygen levels
simulating 8,000 to 10,000 feet in altitude.
Arterial Blood Gas (ABG) Analysis
ABG analysis measures the blood's acidity (pH), partial pressure of
carbon dioxide, partial pressure of oxygen and oxygen saturation at rest
and/or at peak exercise.
Physical Performance Walk Test
This test measures the distance (in feet) that a patient walks during a
six-minute period, while oxygen saturation and heart rate are monitored
by pulse oximetry. The patient's heart rhythm may be recorded via ECG if
Fiberoptic bronchoscopy enables direct visualization of a patient's
upper and lower airways and the collection of specimens or removal of
Therapy and Wellness Services
For patients with chronic lung diseases, a six-week outpatient program
provides exercise therapy, education and emotional support. Patients are
encourage to pursue functional independence and minimize the
debilitating effects of their disease.
Patients who have completed the pulmonary rehabilitation program
can continue to use our exercise facilities in order to maintain their
Inspiratory Muscle Training
Our trainers teach patients techniques to strengthen their ventilatory
muscles and increase their endurance.
Positive Expiratory Pressure (PEP) Therapy
PEP devices, such as a flutter, help patients clear their airways by
using pressure to move bronchial secretions (mucus) so they can be
coughed out. PEP therapy is also used to treat atelectasis
Transtracheal Oxygen Therapy
Transtracheal oxygen therapy delivers supplemental oxygen directly into
the trachea through a small, flexible catheter. This method replaces the
nasal cannula. The catheter is inserted by way of a minor outpatient
surgical procedure using local anesthesia.
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Learn More about Bryn Mawr
Hospital's Pulmonary Diagnostic and Wellness
For more information, call 1.866.CALL.MLH.