Pulmonary Diagnostic and Wellness Center

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 outpatient basis.

Conditions Treated

The conditions we treat include:

• Asthma
• Emphysema
• Bronchitis
• Influenza
• Sleep disorders

Diagnostic Services

The center offers the latest in lung function tests (LFTs) and related procedures.

Spirometry

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 suspected condition.

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 patitent's heart rhythm may be recorded via ECG if requested.

Fiberoptic Bronchoscopy

Fiberoptic bronchoscopy enables direct visualization of a patient's upper and lower airways and the collection of specimens or removal of foreign objects.

Therapy and Wellness Services

Pulmonary Rehabilitation

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.

Exercise Maintenance

Patients who have completed the pulmonary rehabilitation program can continue to use our exercise facilities in order to maintain their health.

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 (collapsed lung).

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.