Pulmonary Medicine

Pulmonary, critical care and sleep medicine specialists at Amrita hospital, Kochi are experts in solving all complex medical challenges faced by people with conditions that affect the lungs. Comprehensive pulmonary medicine programmes include specialized treatment of diseases such as asthma, chronic obstructive pulmonary diseases, sleep-disordered breathing, interstitial lung diseases, cystic fibrosis, occupational lung diseases, pulmonary rehabilitation, tuberculosis, lung cancers and pleural pathologies. The Pulmonary Medicine team at Amrita collaborates with experts in nearly every specialty to provide patients with the best possible care.

• Bronchial Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Sleep-Disordered Breathing
• Interstitial Lung Diseases
• Bronchiectasis
• Cystic Fibrosis
• Occupational Lung Diseases
• Tuberculosis
• Pneumonia & Lung Infection
• Lung Cancers
• Pleural Diseases

• General Pulmonology
• Critical Care medicine
• Sleep Medicine
• Highly experienced, skilled, dedicated and qualified faculty
• Advanced pulmonary function & sleep labs
• State-of-the-art Interventional Pulmonary services
• Specialty clinics
• Second department in India to establish super specialty training program (DM) in Pulmonary Medicine

Our Pulmonary Function Lab offers a range of diagnostic tests, including spirometry, DLCO assessment, and the Six Minute Walk Test, providing comprehensive evaluation and monitoring for respiratory conditions in an outpatient setting.

The Sleep Breathing Disorder Assessment Lab conducts polysomnography and C-PAP titration, allowing for the diagnosis and management of sleep-related breathing disorders through outpatient consultations and interventions.

Patients can benefit from allergy skin testing and immunotherapy, administered in our outpatient facility, offering relief and management options for allergic respiratory conditions.

Our outpatient Bronchoscopic Facilities provide diagnostic and therapeutic bronchoscopy services and pleural service facilities in our outpatient suite.

To book appointments contact: 0484 – 2858650, 0484 - 6688650

• With a team of highly experienced, skilled, and dedicated faculty, we ensure personalized care tailored to your specific needs, providing expertise in managing complex pulmonary conditions.
• Our state-of-the-art pulmonary function and sleep labs utilize advanced technology to accurately diagnose and monitor respiratory disorders, ensuring precise treatment plans for optimal outcomes.
• As pioneers in interventional pulmonary services in India, we offer cutting-edge procedures to address a wide range of pulmonary diseases, providing innovative solutions for our patients' respiratory health.

• Our comprehensive pulmonary medicine programs encompass specialized treatment for various conditions such as asthma, COPD, and interstitial lung diseases, ensuring holistic care for patients with diverse respiratory needs.
• From pulmonary rehabilitation to specialty clinics addressing specific lung conditions, we provide a multidisciplinary approach, collaborating with experts across specialties to offer the best possible care.
• As the second department in India to establish a super specialty training program in Pulmonary Medicine, we are committed to advancing medical education and training future generations of pulmonary specialists, ensuring excellence in patient care for years to come.

OP/IP Services

Respiratory ICU

• Invasive and Non-invasive ventilator support
• ECMO-Extracorporeal membrane oxygenation

Pulmonary Function Lab

• Spiromtery
• DLCO-Diffusion capacity of Lung for Carbon Monoxide
• Six Minute Walk Test
• Cardio Pulmonary Exercise Testing
• Body Plethesmography

Pulmonary Rehabilitation Lab

• Supervised Exercise Training
• Breathing Exercises
• Bronchial Hygiene Techniques
• Oxygen Therapy
• Nutritional and Psychological Counselling

Sleep Breathing Disorder Assessment Lab

• Polysomnography (Sleep Study)
• C-PAP Titration and administration

Allergy Skin Test and Immunotherapy

Bronchoscopic Facilities in OPD Suite

Diagnostic Bronchoscopy

• Bronches-Alveolar wash lavage
• Transbronchial Needle Aspiration
• Transbronhial Brushing
• Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA)
• Transbronchal Lung Biopsy
• Paediatric Bronchoscopy

Advanced Interventional Pulmonology Services

• Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA)
• Rigid Bronchoscopy - Adult and Paediatric
• Rigid Bronchoscopy guided Transbronchial Lung Cryobiopsy
• Rigid Bronchoscopy guided CryoAblation
• Rigid Bronchoscopy guided Foreign Body Retrieval
• Radial EBUS guided Transbronchial Needle Aspiration and Transbronchial

Lung Cryobiopsy

• Endobronchial Debulking for Central Airway Tumours using Electrocautery, APC and Cryotechniques
• Tracheal Stenosis Repair - Pulmonary Balloon Dilatation
• Airway Stenting Procedures - Silicon and Metallic for Critical Airway
• Stenosis
• Laser Technique for Critical Airway Stenosis and Central Airway Tumour
• Medical Thoracoscopy (Flexi- Rigid & Rigid)
• Whole Lung Lavage
• Paediatric Bronchoscopy
• Tracheobronchomalacia Bronchoscopic Repair
• Bronchial Thermoplasty (For Uncontrolled Asthma)

Therapeutic Bronchoscopy

• Foreign Body Removal
• Bronchoscopy guided Tracheostomy

Pleural Service Facilities in OPD Suite

Ultrasonography Chest

• USG guided Thoracocentesis
• Intercostal Tube Drainage and Pigtail Catheter placement for Pleural Effusion and Pneumothorax
• Indwelling Pleural Catheter
• Medical Thoracoscopy (Flexi- Rigid)

We are dedicated to creating a warm and safe healing environment for you and your family, where compassionate care meets cutting-edge medical expertise. Within our pulmonary department, this philosophy resonates strongly as our specialists work tirelessly to enhance respiratory health, pioneering innovative treatments and nurturing the next generation of medical professionals. We ensure that every patient receives the highest quality care and support, with the tools they need to lead healthier, happier lives.

Pulmonary Rehabilitation

Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions. Pulmonary rehabilitation help the patients to breathe easier and improve their quality of life for certain lung conditions. Pulmonary rehabilitation can also help gain strength, reduce symptoms of anxiety or depression, and make it easier to manage routine activities, work, and outings or social activities.

Smoking Cessation Program

Patient education is provided, and the motivation to stop smoking is discussed. Pharmaceutical intervention may be offered where appropriate, and counseling is also offered to patients attending the clinic and on a follow up basis as needed.

Difficulty Asthma Clinic

Asthma patients who are treated on an outpatient basis are periodically scheduled for group presentations about asthma, including different types of the disease, common symptoms, frequently used medicines, inhalers, and accessory equipment. Patients are shown how to use peakflow machines and are taught self-management techniques for their use at home.

ILD Clinic

Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. Lung damage from ILDs is often irreversible and gets worse over time.

Advanced Pulmonary Function Tests with Diffusion, Impulse Oscillometry

Pulmonary Function Tests (PFT's) are useful in diagnosing various lung disorders. They also measure the degree of impairment due to disease. The progression of a disease and the effectiveness of treatment can be carefully observed with regularly scheduled testing. Pulmonary Function Tests are also used frequently to assess preoperative risk and are done supervised by the chief respiratory technician. An impulse consisting of a mixture of sound waves of different frequencies is generated by the loud speaker at the mouth. As this wave passes into the lungs, it causes changes in pressure as well as in the flow of air. The frequencies of the waves delivered in IOS ranges from 5 to 30 Hz.

Flexible Video Bronchoscopies

Bronchoscopies are useful in the investigation of such problems as coughing or an abnormal chest x-ray and are performed under local anesthetic. A modern endoscopy suite with fluoroscopy is available for outpatient and inpatient bronchoscopies. A fiberoptic bronchoscopy system with video and photographic capability is used for performing bronchoscopies which helps in the complete visual assessment of air passages and in making an accurate diagnosis of infection, cancerous changes, and also in obtaining biological samples for pathological examinations.

EBUS (Endobronchial Ultrasound)

EBUS (Endobronchial ultrasound) is ultrasound combined with bronchoscopy to obtain images in and around the bronchial tree or the lungs. This is an advanced diagnostic technology that provides real-time imaging of abnormalities inside the chest. The greatest benefit of using EBUS for evaluating the central airway is that the patient can potentially avoid having to undergo a more invasive surgical procedure and can eliminate the need for additional phases of testing. In addition, because EBUS is performed under conscious sedation, patients recover quickly and can generally go home the same day. There are several indications for endobronchial ultrasound (EBUS)

• Staging of lung cancer
• Diagnostic evaluation of endobronchial lesions, peripheral pulmonary nodules, mediastinal abnormalities, lymphadenopathy
• Guidance of endobronchial therapy

High Resolution CT

High Resolution CT Computed Tomography (CT) imaging, also known as 'CAT scanning’ (Computed Axial Tomography), provides high resolution imaging for cases of lung diseases, mediastinal diseases, and chest wall tumors. The software for spiral CT creates a CT endoscopy and a CT bronchoscopy, as well as a continuous helical acquisition which provides a 3-D volume scan allowing a radiologist to better localize very small tumors.

Thoracoscopy & Pleural Biopsy

Thoracoscopy is a procedure a doctor uses to look at the space inside the chest (outside of the lungs). This is done with a thoracoscope, a thin, flexible tube with a light and a small video camera on the end. The tube is put in through a small cut made near the lower end of the shoulder blade between the ribs. A pleural biopsy is a procedure to take a small piece of the pleura. This is done with a special biopsy needle. Or it’s done during surgery. The biopsy is done to look for infection, cancer, or another condition.

Allergy Clinic & Allergy Testing

Allergy testing identifies allergens, like mold, pet dander, bee stings and peanuts, that can cause allergies. During a skin prick test, a healthcare provider introduces allergens into your skin to check for a wheal (raised mark), rash or other reactions. Blood tests can check for IgE antibodies. The results can help you take steps to manage allergies.

• Difficult Asthma and Allergy Clinic
• ILD Clinic
• Sleep Apnea and Sleep Breathing Disorder Clinic
• Advanced Interventional Pulmonology Clinic
• Pleural Clinic
• Post Covid Clinic
• Lung Cancer Screening
• Smoking Cessation Clinic

Bronchial asthma

Asthma is a long-term disease of the lungs. It causes the airways to get inflamed and narrow which makes it hard to breathe. Severe asthma can cause trouble talking or being active. People with asthma have symptoms when the airways tighten, inflame, or fill with mucus.

There are three major signs of asthma:

Airway blockage - When you breathe as usual, the bands of muscle around the airways are relaxed, and air moves freely. But during asthma attack, the muscles tighten. It’s harder for the air to pass through.

Inflammation - Asthma causes red, swollen bronchial tubes in the lungs. This inflammation can damage the lungs. Treating this is key to managing asthma in the long run.

Airway irritability - People with asthma have sensitive airways that tend to overreact and narrow when they come into contact with even slight triggers.

Chronic obstructive pulmonary disease

COPD (chronic obstructive pulmonary disease) is a group of lung diseases that make it hard to breathe and get worse over time. Normally, the airways and air sacs in the lungs are elastic or stretchy. When we breathe in, the airways bring air to the air sacs. The air sacs fill up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out. If you have COPD, less air flows in and out of your airways because of one or more problems:

• The airways and air sacs in the lungs become less elastic
• The walls between many of the air sacs are destroyed
• The walls of the airways become thick and inflamed
• The airways make more mucus than usual and can become clogged

Sleep-disordered breathing

Sleep disordered breathing (SDB) refers to a wide spectrum of sleep-related conditions including increased resistance to airflow through the upper airway, heavy snoring, marked reduction in airflow (hypopnea), and complete cessation of breathing (apnea). Increased resistance to airflow without frank apnea has been referred to as upper airway resistance syndrome; apneas and hypopneas are classified as central, obstructive, or mixed;

Patients with sleep disordered breathing can experience daytime symptoms, such as sleepiness or excessive somnolence, depressed mood, irritability, and cognitive dysfunction that can adversely affect quality of life.

Interstitial lung diseases

Interstitial lung disease refers to a group of about 100 chronic lung disorders characterized by inflammation and scarring that make it hard for the lungs to get enough oxygen. The scarring is called pulmonary fibrosis.

The symptoms and course of these diseases may vary from person to person. The common link between the many forms of the disease is that they all begin with inflammation.

• Bronchiolitis: inflammation of the small airways (bronchioles).
• Alveolitis: inflammation of the air sacs where oxygen and carbon dioxide exchange in the blood takes places (alveoli).
• Vasculitis: inflammation that involves the small blood vessels (capillaries).

Bronchiectasis

Bronchiectasis is a lung condition that causes coughing up of mucus. In the lungs, the bronchi are the passages that allow air to enter the lungs. In bronchiectasis, the inside surfaces of the bronchi get thicker over time from inflammation that leave scars. Thicker walls cause mucus to collect in these passages because the walls are not strong enough to make the mucus move out of the lungs.

Cystic Fibrosis

Cystic fibrosis (CF) is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with CF, a defective gene causes the secretions to become sticky and thick. Instead of acting as lubricants, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. The thick mucus can also block tubes that carry digestive enzymes from the pancreas to the small intestine.

Occupational Lung Diseases

Work-related lung diseases or occupational lung diseases are lung problems that are made worse in certain work environments. They are caused by long-term exposure to certain irritants that are breathed into the lungs. These lung diseases may have lasting effects, even after the exposure ends.  These sources include factories, smokestacks, exhaust, fires, mining, construction, and agriculture. The smaller the particles are, the more damage they do to the lungs. Smaller particles are easily inhaled deep into the lungs.

Tuberculosis

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.

Although the body can harbor the bacteria that cause tuberculosis, the immune system usually prevents it from becoming sick. For this reason, doctors make a distinction between:

Latent TB – A person has a TB infection, but the bacteria in the body is inactive and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. Latent TB can turn into active TB, so treatment is important.

Active TB - Also called TB disease, this condition makes an individual sick and, in most cases, can spread to others. It can occur after weeks or years of infection with the TB bacteria.

Pneumonia & Lung infection

Pneumonia is an infection in one or both lungs caused by bacteria, viruses, or fungi. The infection leads to inflammation in the air sacs of the lungs, which are called alveoli. The alveoli fill with fluid or pus, making it difficult to breathe. Both viral and bacterial pneumonia are contagious. This means they can spread from person to person through inhalation of airborne droplets from a sneeze or cough.

You can also get these types of pneumonia by coming into contact with surfaces or objects that are contaminated with pneumonia-causing bacteria or viruses.

Lung Cancers

Lung cancer is cancer that forms in tissues of the lung, usually in the cells that line the air passages. It is the leading cause of cancer death in both men and women. Lungs are two spongy organs in the chest that take in oxygen when we inhale and release carbon dioxide when we exhale.

People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. The risk of lung cancer increases with the length of time and number of cigarettes smoked by the person. If a person quit smoking, even after smoking for many years, it can significantly reduce the chances of developing lung cancer.

• DM in Pulmonary Medicine

Phone: 0484 – 2858650, 0484 - 6688650

Email: [email protected]