Our respiratory service specialises in treating patients with a wide variety of respiratory problems.
Consultants in respiratory medicine are available on a daily basis to see patients with a variety of respiratory problems.
They see these patients either in our Lodge Road facility in St John's Wood or at our satellite Outpatient Centres located in Golders Green and Elstree .
Conditions & treatments covered
Patients typically have the following conditions: Asthma, Chronic obstructive pulmonary disease (COPD), Bronchiectasis, Sleep-related problems such as sleep apnoea, Tuberculosis, Pneumonia, Lung cancer, Interstitial lung disease, Occupational lung diseases, Pleural disease and Pulmonary vascular disorders.
Patients may also be suffering from respiratory conditions which result from an underlying medical condition. The respiratory specialists liaise closely with colleagues from other medical, surgical and diagnostic disciplines, such as cardiology, thoracic surgery, rheumatology, radiology, infectious diseases, neurology, oncology, ENT surgery, and intensive care.
Some common symptoms related to the respiratory tract include breathlessness, cough (either dry or productive), wheeze, chest discomfort or pain, snoring and daytime sleepiness. There may also be an allergic or seasonal variation in symptoms.
It is estimated that in 2011 over one billion people travelled by air and over the next 20 years that figure is expected to double. With this increase in air travel and an increasingly ageing population, there will be a significant increase in the number of older passengers and those with illness who wish to travel. The physiology of flying, and its impact on a patient's underlying illness, is important in assessing whether a patient is fit to fly.
Most cardiac conditions can tolerate air travel well, although individual assessment is recommended, but certain respiratory conditions require more detailed investigation. The majority of patients with lung disease who will experience in-flight hypoxia can fly safely with supplemental oxygen, but it's important that this is assessed first.
The following groups should be assessed: severe COPD or asthma; severe restrictive disease (including chest wall and respiratory muscle disease), especially with hypoxaemia and/or hypercapnia, patients with cystic fibrosis, history of air travel intolerance with respiratory symptoms (dyspnoea, chest pain, confusion or syncope), co-morbidity with other conditions worsened by hypoxaemia (cerebrovascular disease, coronary artery disease, heart failure, pulmonary tuberculosis; if they are within six weeks of hospital discharge for acute respiratory illness, a recent pneumothorax, at risk of or previous venous thromboembolism and a pre-existing requirement for oxygen or ventilator support. For the majority of these patients it is recommended that they should undergo a hypoxic inhalation test (HIT).
A HIT is a relatively straight forward test, firstly requiring an earlobe blood gas sample from the patient to assess the baseline oxygen levels. The patient then breathes in a mixture of oxygen and nitrogen, which simulates the cabin environment. Oxygen saturation is monitored and a further earlobe sample is taken to assess the amount of de-saturation. If the oxygen saturation drops to a certain level, then supplemental oxygen is administered until the de-saturation is rectified.
If in-flight oxygen is required most airlines will provide this, although some charge a fee for the privilege. The method of oxygen delivery depends upon the specific aircraft, but the supply is usually from cylinders. In some aircraft, oxygen can be tapped from the `ring main' of oxygen. International regulations allow passengers to use their ow oxygen on board aircraft and to carry small, full oxygen cylinders (for medical purposes) with them as baggage, provided they have the approval of the airline concerned - patients must check with the airline first.
What does a Cardio Pulmonary Exercise Test measure?
Cardiopulmonary exercise testing is a non invasive measure of the response of the heart and lungs to exercise. The test will provide lots of information that may be used to assess amongst other things, limitations to exercise, suitability for surgery and as a measure of general fitness. The test will be performed on a cycle ergometer (the stationary bike that you would use in a gym) and as you cycle we will measure how much air you breathe, how much oxygen you need and how fast and efficiently your heart beats.
To measure the amount of air that you breathe you will need to wear a mouthpiece and a soft nose clip. An ECG (electrocardiogram) will check the electrical activity of your heart and a small peg on your finger will measure how much oxygen is in your blood.
Where will I have the test?
The Cardio Pulmonary Exercise test are carried out in the Lung function laboratory
What will the test involve?
The test will involve the respiratory physiologist firstly explaining the procedure of the test. Please feel free to ask questions and share any concerns at this time.
To monitor your heart during exercise, adhesive patches called electrodes will be put on your chest. Your chest will be cleaned with alcohol and shaved in some areas (if necessary) before these electrodes are put in place. This does not hurt. You will be asked about any symptoms you have had while exercising in the past. Please try to describe as best as you can any chest discomfort, breathing problems, lightheadedness, dizziness, fluttering in the chest, weakness, tiredness, or anything else you think may be relevant.
Your heart rate and rhythm, breathing rate, the amount of oxygen you use and how much oxygen is in your blood (finger probe) will all be checked during the test. To begin with a resting measurement, lasting three minutes, will be taken. During this time you will be sat on stationary on the bicycle. After this you will be asked to cycle at a comfortable pace, every two minutes the a small incremental resistance will be placed onto the pedals making it slightly more demanding for you maintain the same speed of cycling
As the mouthpiece will be in place you will be told to give hand instructions to reply to the physiologist's questions during the test. You should breathe as normally as possible through the mouthpiece during the test. It will feel a little bit strange at first, but it is not uncomfortable or painful.
You will be encouraged to continue pedaling until you are unable to go any further and you have your reached your maximal exercise capacity. The physiologist may stop the test if he/she has all the information that is needed and you will be able to stop the test at any point if you are feeling uncomfortable When you completed the test your breathing, heart rate and oxygen level will continue to be monitored as you recover. All these instructions will be carefully explained to you on the day.
How long will the tests take?
Normally between 30 to 60 minutes, although the exercising element of this test usually last approx 15mins depending on your level of fitness.
Lung Function Tests (LFTs) are breathing tests, often referred to as Pulmonary Function Tests (PFTs). Doctors may ask for lung function tests for many reasons:
To assess how well we breath in and out
To see if our lungs are working correctly
Measure the lungs capacity to transfer oxygen and other gases
Assess how medication might help with our breathing
As an anaesthetic assessment before an operation
You may have a whole range of tests performed or just one simple test, but this will depend on the reason for testing. This means that the test may take anything from 15 minutes to over an hour. You will be given all the information you need when you receive your appointment.
Where will I have the test?
The Lung Function Tests are carried out in the Lung function laboratory on the 1st Floor of The North tower
We will try to make your lung function test on the same day as your appointment with the respiratory consultant Unfortunately, this won’t always be possible so please check carefully the date and time of your appointment.
What will the test involve?
The basic lung function test has three parts: spirometry, gas transfer, and lung volumes. You will breathe into a mouthpiece, which is attached to a machine. You will also wear a nose peg during tests, so that you only breathe through your mouth. The tests are completely painless and should not cause you any discomfort.
A pulmonary physiology laboratory (also known as Lung Function) is located in The Wellington North building where a full range of tests can be carried out to aid in the diagnosis and manage respiratory conditions.
Also available are physiological tests (Pulmonary or Lung Function Tests) to help determine whether someone is fit for surgery or fit to fly.
To help make some of our more popular treatments more accessible, we guarantee to fix the price of your treatment prior to it taking place. Click here for more information about the Self Pay options we offer as part of HCA Healthcare UK.