The Pulmonary Diagnostic and Wellness Center at Paoli Hospital provides
comprehensive care for patients with severe respiratory disorders and
chronic lung diseases, including asthma, emphysema, pneumonia, lung
cancer, sleep apnea and chronic obstructive pulmonary disease
Our respiratory care physicians and therapists provide a full range of
services to help patients breathe easier, including diagnostic testing,
respiratory care, pulmonary
rehabilitation, sleep medicine, integrative medicine and an
aftercare program. Programs are available on both an inpatient and
The Pulmonary Diagnostic and Wellness Center offers a full range
of services including:
Diagnostic Services: The center offers
the latest in lung function tests (LFTs) and related
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 patient'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.
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
Honors and Awards
Paoli Hospital Pulmonary Rehab and
Pulmonary Function Lab Awarded Certification
from the Joint Commission
For more information, call 1.866.CALL.MLH.