Pneumology

Ambulatory Polysomnography is a comprehensive sleep assessment test, including EEG (brain activity) recording, eye movements, muscle activity, respiratory flow, and oxygenation, often supplemented with video monitoring.

It is indicated for the diagnosis of sleep disorders such as obstructive sleep apnea, periodic limb movements, sleepwalking, and parasomnias. 

The test is performed at night in a controlled environment, allowing for the identification of sleep disturbances, episodes of apnea, and cardiovascular impact. 

Level III sleep polygraph recording, or cardiorespiratory polygraph study, is a non-invasive and painless test that is safe for the patient, with no side effects, risks, or complications. 

This test is performed on an outpatient basis, using small portable equipment with accessories such as a nasal cannula, oximeter, and two chest and abdominal straps, allowing for detailed monitoring during sleep. 

The test evaluates various sleep parameters, including body position, oronasal flow, thoracic and abdominal respiratory movements, oxygenation, and heart rate. It is mainly indicated for the diagnosis of sleep apnea, but it is also useful in cases of snoring, obesity, or in patients with cardiovascular diseases. 

Nocturnal transcutaneous oximetry allows for the diagnosis of significant drops in oxygen saturation (oxygen desaturation) during sleep and assesses the need for nocturnal oxygen therapy. 

The test indirectly measures blood oxygenation using a sensor placed on the finger, connected to a pulse oximeter, which continuously records oxygen levels throughout the night. This non-invasive method allows changes in saturation to be monitored and episodes of hypoxemia during sleep to be identified. 

Obstructive Sleep Apnea Syndrome (OSAS) and Chronic Obstructive Pulmonary Disease (COPD) are indications for this test. 

The alveolar-capillary diffusion test, also known as DLCO, is indicated for the evaluation of interstitial lung diseases and pulmonary vascular diseases, including chronic pulmonary thromboembolism, pulmonary vasculopathies, rheumatological diseases, and vasculitis, as well as idiopathic pulmonary arterial hypertension. 

This test evaluates the ability of gases to pass through the pulmonary alveoli (transfer of oxygen to the blood and removal of carbon dioxide) to assess the alveolar surface available for gas exchange. 

During DLCO, breathing is performed through a mouthpiece with a nose clip while the patient inhales a controlled volume of harmless gas, ensuring safe and accurate measurements of lung function. 

Arterial blood gas analysis is an essential test for assessing oxygenation, ventilation, and acid-base balance in the body.

It is performed by collecting a sample of arterial blood, usually from the wrist, allowing oxygen, carbon dioxide, pH, and other blood parameters to be measured. 

Blood gas analysis is indicated in chronic respiratory diseases, acute respiratory failure, monitoring of oxygen therapies, and assessment of associated metabolic disorders. 

The bronchoconstriction test, also known as inhaled bronchial provocation, is an examination used to assess airway hypersensitivity. This hypersensitivity is often associated with asthma and other respiratory diseases characterized by inflammation or obstruction of the airways. 

During plethysmography, a bronchoconstrictor drug is administered, causing a temporary contraction of the airways, and their response to the stimulus is assessed. 

The measurement of exhaled nitric oxide (FeNO) is a non-invasive test that assesses the degree of bronchial inflammation. This test is especially useful for the diagnosis and monitoring of asthma, as well as in patients with persistent or prolonged cough. 

The procedure is simple: the patient performs a controlled exhalation into a tube connected to a reading device, which measures the levels of nitric oxide (NO) in the exhaled air. The results allow the identification of inflammation in the airways and assist in evaluating the effectiveness of treatment. 

Spirometry is a respiratory test that assesses lung function by measuring lung volumes and airflow. This test is widely used in the diagnosis of respiratory diseases, as well as in classifying the severity of the disease and monitoring the effectiveness of medication over time. 

During spirometry, airflow is measured based on the volume of air that the lungs can move through maximum inspiratory and expiratory maneuvers, either forced or slow. 

In certain situations, a bronchodilator drug may be administered, and spirometry is then repeated. This procedure, known as a bronchodilation test, allows the response of the airways to the medication to be assessed and is especially useful in monitoring conditions such as asthma or COPD. 

The walking test, also known as the 6-minute walk test, is an examination used to assess functional physical capacity and objectively measure symptoms such as dyspnea (shortness of breath) and fatigue.  

This test is especially useful for monitoring response to therapy in patients with lung or heart disease, allowing for personalized treatment adjustments. 

During the test, the patient walks for 6 minutes on a flat, obstacle-free path at a speed and pace that is comfortable for them. The goal is to determine the longest distance traveled, providing a practical measure of physical endurance and respiratory function.  

Throughout the test, blood oxygen levels (saturation), heart rate, and blood pressure are monitored. 

Total body plethysmography is a benchmark test for diagnosing airway obstruction and lung expansion restriction.

Plethysmography measures total lung capacity, airway resistance, and residual volume, which is the amount of air that remains in the lungs after a maximum exhalation.  

The test is performed inside a closed cabin, ensuring controlled conditions for measuring lung volumes. During the test, the patient performs several breathing maneuvers of varying effort, including inhalations and exhalations, using a mouthpiece and nose clip to ensure the reliability of the results. 

Chest radiography (chest X-ray) allows for quick and effective analysis of infections, nodules, pleural effusions, and structural changes, making it a first-line test for respiratory diseases. 

Chest tomography (CT scan) offers a more detailed, three-dimensional view, allowing for accurate identification of lung lesions, tumors, pulmonary thromboembolism, and interstitial diseases.