THE PULMONARY FUNCTION LABORATORY

The Pulmonary Function Laboratory of the American Hospital offers a multidisciplinary service to measure functions of the pulmonary system in line with up-to-date related literature. Carefusion devices are used in our laboratory.
 
Which tests are performed at the Pulmonary Function Laboratory?
 
Spirometry and Reversibility (Bronchodilator) Testing
A spirometer is a device that measures lung functionality; the associated test measures flow and volume of air inhaled and exhaled to determine efficiency. A short-acting bronchodilator agent is inhaled by patients if required in order to evaluate the reversibility of bronchial obstruction. Your doctor may instruct you to temporarily cease ingesting certain medication varieties before a reversibility test is performed; you should discuss any potential change involving temporarily adjustments to your drug regimen with your doctor before each test.



Methacholine Challenge Test
Bronchial hypersensitivity is one of the symptoms that may contribute to asthma diagnosis.  When asthma is suspected, but there is no sign of bronchial obstruction in the pulmonary function test, this test is subsequently performed to determine bronchial hypersensitivity. Your doctor may instruct you refrain from using certain drugs before the provocation test is performed. As previously mentioned you should discuss any potential adjustment to your drug regimen with your doctor before each test.
 
Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO Test)
Diffusion is the underlying mechanism of gas exchange in the lungs. Diffusion implies how much oxygen travels from the alveoli of the lungs to the bloodstream. This gas transfer or exchange is determined with diffusion permeability of the lungs. Since carbon monoxide (CO) is 210 times more efficient at binding to hemoglobin than oxygen, the diffusion capacity of the lungs is estimated in this test by inhaling a very low concentration of CO2 (0.3%). Since smoking increases the concentration of CO in alveoli, it is recommended to refrain from smoking 24 hours before the test. If a patient is unable to cease smoking for the recommended period, carboxyhemoglobin is measured in exhaled air (exhaled COhb) instead. Since hemoglobin is responsible for transporting oxygen, the data in these cases are carefully analyzed and adjusted to achieve an authentic lung efficiency result. The up-to-date range for hemoglobin is required in this case.


 
Measurement of Lung Volumes Using Body Plethysmography
A plethysmograph is a device that measures elasticity, the diameter of pulmonary tracts and other functional details that cannot be estimated by spirometry. The basic function of Body Plethysmograph is the direct evaluation of lung volumes using intra-thoracic gas volume measurements. Thanks to high-tech devices, this test can be completed within a short time while the person is inhaling and exhaling and it offers us a wide range of physiological parameters.



Measurement of Maximal Inspiratory and Expiratory Pressure (MIP, MEP)
Measurement of Maximal Inspiratory and Expiratory Pressure is used for diagnosis and follow-up of suspected or documented diseases associated with loss of strength in the respiratory muscles. Maximal Inspiratory Pressure (MIP) measures the strength of diaphragmatic and other inspiratory muscles during maximal inspiratory effort against a closed valve, while Maximal Expiratory Pressure (MEP) determines the strength of abdominal and other expiratory muscles. P0.1 (pressure in airways 100 milliseconds after inspiration starts) is measured during normal breathing and it offers indirect information about the central drive in the respiratory center.
 
Six Minute Walk Test
An easy test that is used to determine cardiopulmonary and functional capacity, the efficiency of treatment and condition prognosis. This test does not require special equipment and the patient walks maximal possible distance over a span of 6 minutes. Blood pressure, oxygen saturation (finger), pulse and dyspnea are monitored before and at the end of each test.  Patients are given oxygen support if required to determine the optimal oxygen needed. After each test is completed, collected data and overall walking distances are recorded and analyzed.
 
Cardiopulmonary Exercise Testing (VO2 Max Test)
Parameters of cardiopulmonary capacity that cannot be estimated accurately while a patient is in a state of rest are measured during exercise yielding extremely detailed information concerning many diseases. Functional reserves of organs that play a role in exercise are determined along with the factors that limit the exercise. Basically, a treadmill (in our unit) or a cycle ergometer is used under standard exercise protocols. Your doctor will inform you about patient-specific contraindications of the test.



What are the intended applications of the VO2 Max Test?

• Differential diagnosis of pulmonary diseases
• Vascular diseases and follow-up (Pulmonary Arterial Hypertension)
• Cardiovascular diseases
• Muscle diseases (differentiation from myopathy)
• Preoperative evaluation (especially for determining risks before lung and cardiac surgery)
• Evaluating response to treatment
• Evaluating condition and exercise intolerance
• Evaluation of disability

 
The test requires certain preparations. It is necessary to wear comfortable clothes and avoid smoking and consuming caffeinated beverages in the run-up. It is also necessary that patients should avoid food two hours before the test. Moreover, we recommend patients bring their pulmonary function test report as well as chest X-rays, tomography, laboratory tests, ECG and ECHO plus all relevant consultation notes. If you use an inhaler you should take your drugs at the usual time. If you use beta-blockers or calcium channel blockers (drugs that regulate heart rhythm), you should remind your doctor and our laboratory personnel before the test. Please schedule an appointment in advance.
 
Exhaled Nitric Oxide (FENO) Test
FENO (Fractional Exhaled Nitric Oxide) is a testing procedure that measures non-microbial inflammation of the airway. The concentration of nitric oxide produced in the lungs and exhaled increases substantially in chronic inflammatory diseases, such as asthma. FENO can be used for COPD, the differential diagnosis for patients with chronic cough, sarcoidosis, and bronchiectasis. FENO is a simple test that requires a breathing maneuver lasting for 10-12 seconds.

Please schedule an appointment in advance: 444 3 777 / 4772 and 7836