Pulmonology

RoNeuro Institute, Cluj-Napoca, Romania

Pulmology is the specialty that deals with the detection, diagnosis, treatment and recovery of patients suffering from diseases of the respiratory system (from respiratory viruses, tracheobronchitis, acute or chronic bronchitis, viral or bacterial pneumonia, pulmonary tuberculosis, chronic obstructive pulmonary disease, chronic asthma, bronchial asthma respiratory failure, pulmonary fibrosis, sarcoidosis and interstitial lung disease until bronchopulmonary cancer, mediastinal pathology or respiratory disorders during sleep).

Clinical investigations

  • Cardio-respiratory polygraphy

    Nocturnal cardiopulmonary polygraphy is a diagnostic method useful in establishing the diagnosis of obstructive sleep apnea syndrome when clinical suspicion is high. The cardio-respiratory polygraph is a portable device, which is mounted to the patient by means of sensors, and the patient can sleep at home connected to this device.

    During the night the parameters necessary for establishing the diagnosis are recorded:

    • airflow (recorded through the nasal cannula)
    • oxygen saturation in arterial blood and ventricular allure (pulse oximetry)
    • snoring
    • chest effort
    • body position during sleep

    After registration, it is necessary to interpret the nocturnal route by manual validation by the doctor.

    The choice of the therapeutic variant in the case of obstructive sleep apnea syndrome is made according to the severity of the disease, taking into account the index of apnea-hypopnea, the clinical picture and the presence of the associated diseases, thus involving interdisciplinary collaboration (pneumologist, ENT, cardiologist, diabetes-nutritionist, etc.).

    Continuous positive pressure nocturnal therapy (CPAP) applied through the nasal or oral-nasal interfaces (masks), represents the standard treatment for SASO patients and represents the first line therapy to be considered in this category of patients.

    CPAP acts as a pneumatic brace that prevents airway collapse, a collapse that can only be prevented if the CPAP pressure level is higher than the pressure that caused the airway collapse. CPAP pressure that keeps the airways open is determined by night titration during polygraphy one night after the diagnosis.

    The success of CPAP therapy is influenced by the patient-device interface, respectively the nasal or oro-nasal mask, which differs in model, size and adapts according to the patient.

    Alternative therapies that refer to sleep hygiene, weight loss, exercise, or ENT surgery (but not in the severe forms of SASO) should not be neglected and should be considered for complex treatment of the patient with obstructive sleep apnea syndrome.

  • Spirometry

    Respiratory functional tests are used to evaluate lung function. Tests show how much air your lungs can hold, how quickly you can move air into or out of your lungs, and your lungs' ability to transfer oxygen to and remove carbon dioxide from the blood.

    Spirometry is the most common non-invasive functional breath test, which measures inspiratory air volumes, expiratory air volumes, and how quickly the air in the lungs can be expired.

    Spirometry is used to diagnose a number of lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing. Spirometry can also be used periodically to check the effectiveness of treatment in certain chronic lung diseases.

    During the test the patient will breathe in a flexible tube that is attached to a spirometer, having mounted a nose clip to stop the flow of air through the nasal cavity.