Consistently with a punctual and efficient clinic performance, and in light of the Users’ needs, the Pulmonology Service is structured in the following manner:

1) Respiratory Pathophysiology Service

2) Thoracic Endoscopy Service

RESPIRATORY PATHOPHYSIOLOGY SERVICE

The Pathophysiology Service is equipped with two medical clinics and three large halls, situated near the Multipurpose Clinics, where functional investigations about the physiology of the first and second level respiratory systems are conducted, thanks to the most modern and advanced technologies, fully updated and renewed during the current year.

The Service is accordingly equipped with:

– Two spirometers with ultrasound flowmeter

– A last generation plethysmography cabin

– A pressure regulator for the non-specific provocation test with direct stimulus (methacholine)

– A device for the study of the alveolar capillary diffusion of carbon monoxide

– A device for dosing the exhaled Nitric Oxide

– A Blood Gas Analyser

– A very last generation device to measure objectively and in real time the 6 Minutes Walking Test

– Three oximeters

– An ergospirometry for the exercise test, with the possibility of measuring lung volumes and the alveolar capillary diffusion throughout the stages of the test. The instrument is also equipped with a 12 channel monitor for instant and ongoing visualization of the ECG

– A Treadmill for the ergospirometric exercise test and the provocation so as to study exercise-induced asthma

– A computerized ultrasound for the assessment of the pleural effusions and their possible evacuation (thoracentesis).

The service carries out its activity from eight in the morning till 6.00 pm, Monday to Friday, and targets the internal users (hospital departments) and the external ones, both as activity subsidized by the State-run health care service and as one exercised by independent practitioners.

The functional examinations, given their complexity, envisage a minimum execution period of 15 minutes up to a maximum of 60 minutes. In any case, every examination at the GP’s behest is followed by medical reporting on the part of a specialist pulmonologist and also, when booked, by an immediate clinical visit.

THORACIC ENDOSCOPY SERVICE

Through the extension of the endoscopic plate of the Thoracic Endoscopy itself, the services which are capable of being rendered might also finally target, apart from the users admitted to hospital, even the clinic patient.

According to the new regional regulations, the services might be rendered directly at the GP’s behest or in the day hospital as far as the main performances are concerned: deep sedation, lung biopsies, ultrasound-guided trans-bronchial fine needle aspiration.

The post-examination observation period is of variable duration, as it is related to the achievement of normalization in the vital parameters recorded during the pre-examination visit, and might accordingly vary between one hour and a few hours, depending on the complexity and the type of examination conducted.

The services rendered contemplate the execution of diagnostic examinations with the help of the most modern endoscopic and radiological equipment, both through fluoroscopy, situated in the endoscopic plate, and through the aid of the Computed Axial Tomography (CAT) in the event of small-size pulmonary injuries (equal to or less than 3 centimetres), situated near the Diagnostic Service by Images.

Thanks to these modern technologies, it is therefore possible to diagnose inflammatory, infectious and neoplastic pathologies of the bronchial tree and the lung.

Lastly, through the acquisition of the Ecoendoscopic Ultrasound, it is now even possible to access the external lymph nodes of the bronchial tree, by means of ultrasound-guided transparietal free needle aspiration, so as to diagnose and possibly stage tumors.

To date, the diagnostic sensitivity of the services rendered is equal to 71.

4% and is fully in line with the results recorded in the national and international literature.

Guide to the serviceInformed test consent to cardiopulmonary exercise testInformed consent to bronchial stimulation to methacholineInformation form on bronchoscopyInformed consent to bronchoscopy