Offer

Our pulmonary function laboratory offers all pulmonary function tests on an inpatient and outpatient basis. Breathing tests can be used to examine respiratory performance without any radiation exposure. Deviations from the norm provide important indications of a lung or respiratory disease. Lung function tests can measure the size of the lungs (bodyplethysmography) and the speed of the respiratory burst and respiratory volumes (spirometry). Under certain circumstances, we may stimulate the airways in a further test (bronchoprovocation). If there is a narrowing of the airways, this is seen as an overreaction and is a typical sign of bronchial asthma.

The lung function is supplemented by measuring the gas exchange of the lungs (blood gases, CO diffusion capacity) and determining inflammation values in the exhaled air (eNO). Patients with advanced lung diseases often suffer from a lack of oxygen in the blood, which can be detected with blood gas tests. Oxygen can then be administered at home as a treatment (home oxygen therapy). As lung specialists, we determine the amount of oxygen required for a good oxygen supply (oxygen titration) and carry out regular checks. In some patients, diseases of the muscles or nerves of the respiratory organs are suspected. In this case, the respiratory muscle strength (respiratory mechanics) can be determined.

The above examinations are carried out at rest. Exercise tests must be carried out if the previous tests are not sufficient for the assessment, if we need to find out more about gas exchange under stress or if we want to separate lung problems from heart problems. The simplest examination is the measurement of the walking distance in six minutes (6-minute walk test), the most complex is a so-called spiroergometry, an examination where lung function is performed while cycling and the work of the lungs, heart and muscles is analyzed. This examination is also frequently carried out to determine functional reserves and assess the risk of lung surgery.

Many people suffer from sleep disorders. Breathing-related (respiratory) sleep disorders are a common cause of this. These cause daytime sleepiness and lead to a measurable increase in accidents (microsleeps).

The following examinations are available to clarify sleep disorders:

• Respiratory polygraphy can be used to determine whether sleep and breathing disorders are present using an analyzer similar to a wristwatch, which is worn at home during the night. For further clarification, a nocturnal sleep examination is carried out in the sleep laboratory, which measures not only breathing patterns but also brain waves and many other parameters (polysomnography). Special devices can be used to measure not only oxygen saturation throughout the night, but also the CO2 present in the blood, which, if elevated, is an indication of respiratory insufficiency.

• Patients with respiratory failure require therapy with nocturnal positive airway pressure (CPAP therapy), which is individually adjusted using a computerized system and must then be carried out permanently at home in the evening. Patients with insufficient respiratory drive or neurological and muscular diseases that affect the respiratory muscles are treated with nocturnal home ventilation. After the start of treatment, the effectiveness is checked at regular intervals and the devices are readjusted if necessary.

In addition to the clinical examination, laboratory assessment, computer tomograms and lung function, we also carry out bronchoscopies. Patients are asleep during bronchoscopy, but no anesthesia is required. Bronchoscopies are performed for a wide variety of diseases such as lung infections in immunocompromised patients, suspected lung tumors, interstitial diseases, etc. A wide range of technical options are available. Flushing fluid can be taken for bacteria, viruses and fungi.

During lung endoscopy (flexible bronchoscopy), the large airways are viewed using a thin (3-7 mm thick) controllable fiberglass tube (bronchoscope). Bronchoscopy is not painful. Patients are given a sedative for the examination (no general anesthesia) and are therefore unaware of the examination itself. The examination takes about 10-40 minutes. Patients should "sleep in" for a few hours afterwards and are not allowed to drive on the same day. Patients can usually leave the hospital on their own after a maximum of four hours.

A lung endoscopy enables the examination of abnormalities in the lung tissue, such as

• Shadows on the X-ray (infiltrate),
• nodules,
• scarring of the lung tissue (interstitial changes)
• as well as enlargement of the lymph glands (lymph nodes), which are located between the two lungs.

If there are abnormal findings in the lung endoscopy, the lung specialists can flush the lung with a small amount of fluid (bronchoalveolar lavage), scrape the mucous membrane a little or even take a small tissue sample (transbronchial and endobronchial biopsy). Lung endoscopy is also ideal for quickly and painlessly clarifying small lumps next to the airways (fine needle aspiration). With the new technology, endobronchial ultrasound (EBUS), an ultrasound examination can be carried out via the bronchoscope.

With this method, lymph glands located next to the airways can be visualized and a specific sample can be taken from them. Sometimes we observe that the patient's breathing is obstructed by secretions, tissue or small objects in the airways. If this is the case, this can be suctioned out, pulled out with forceps or even reopened with hot argon gas (argon therapy) or high-energy light (laser application). If the airways are severely constricted from the outside, a supporting mesh tube (stent implantation) can be inserted in a few minutes to keep the airway open. The appropriate probes for local post-radiation therapy (brachytherapy) of the airways can also be inserted.

If a disease of the thin fluid-filled space around the lung (pleural space) is suspected, it can be examined as follows:

• an ultrasound (pleural sonography) is usually performed first. By aspirating excessive fluid or air from this space (pleural puncture), a significant improvement in breathlessness can be achieved or even the cause can be determined. To do this, a very thin needle or a thin tube must be inserted into this space between the ribs under local anesthesia. The tube often has to remain in place for several days (pleural drainage). In a similar way, a sample can be taken (lung and pleural biopsy) or the chest and lungs can also be examined with a video camera (thoracoscopy). A thoracoscopy is performed on patients who are asleep. This allows us to free an adhered lung (adhesiolysis) and bond partially detached lungs to the chest wall (talc pleurodesis). Patients must be admitted to hospital for a few days for this procedure.

This information does not replace any verbal or written explanation by the doctor. If you have any questions, the doctor on duty or your family doctor will be happy to answer them.

International studies are providing increasing evidence that patients are still suffering from health restrictions even months after they have recovered from Covid-19. The extent of these restrictions has not yet been clarified, so regular check-ups with the family doctor and, if necessary, a specialist are advisable.

As lung specialists, we will be happy to assist you if you continue to have breathing problems that make you feel unsafe after contracting Covid-19. Please contact us on +41 61 265 51 80 or pneumo@usb.ch.