Pulmonary Function Tests are used to investigate and monitor many conditions, both respiratory and non-respiratory in nature. These tests can also be used to assess a patient prior to undergoing a procedure such as thoracic surgery or radiotherapy. Many departments also perform sleep studies to investigate a range of sleep disorders.

Asthma

Asthma is a long lasting lung disease in which the muscle surrounding the airways in the lungs tightens, causing them to narrow, become swollen and fill up with an increased level of mucus. It is caused by an over-sensitive reaction to certain substances like house dust, pollen animal hair and tobacco smoke. Environmental conditions like hot or cold air can also have an effect, as can exercise or stress. As a result of these changes, the movement of air in and out of the lungs is reduced. Asthmatic patients may experience breathlessness, wheeze, cough and chest tightness. Asthma can occur at any stage in life, but is most common in childhood. It is also more common within families; you have a higher chance of having Asthma if a relative is an asthmatic. In Ireland, nearly half a million have the disease. In most cases, Asthma can be successfully treated and the symptoms completely reversed. Treatment normally involves inhalers, but sometimes, oral medication is also involved. These treatments reduce the airway swelling and tightening, decrease the level of mucus and open up the airways. Avoidance of the triggers that bring on Asthma will also help.

Idiopathic Pulmonary Fibrosis

Pulmonary Fibrosis is a disease that affects the areas of the lungs in which air is exchanged. These areas become scarred and inflamed to some extent, which affects the movement of oxygen into the blood and the removal of carbon dioxide (waste product). In Pulmonary Fibrosis, patients experience a dry cough (doesn’t produce mucus) and breathlessness. Another result of this scarring is that the lungs become stiff and more rigid, and cannot expand fully. This reduces the capacity of the lungs and adds to the breathlessness. It is a long lasting disease that gradually gets worse over time. The cause of Pulmonary Fibrosis is unknown, but it is thought to arise from an excessive immune response i.e. a situation where the body attacks its own cells. There is no standard treatment for people with Pulmonary Fibrosis and it may differ from patient to patient. It generally involves attempts to reduce the swelling, but has had limited success. In some cases, the disease becomes inactive itself. Many studies and trials are now underway which are trying to develop a new approach to the treatment of the disease. Pulmonary Fibrosis patients can be monitored with Pulmonary Function Tests.

COPD

Chronic Obstructive Pulmonary Disease is a combination of two lung diseases – Chronic Bronchitis and Emphysema. It is a long lasting disease that normally gets worse over time. Chronic Bronchitis is a disease in which the medium sized airways in the lungs become swollen, and fill up with an excess of mucus. This causes the diameter to narrow, reducing the movement of air in the lungs. Emphysema affects the air sacs in the lungs where oxygen and carbon dioxide are exchanged. The walls of these air sacs are weakened and damaged, and become less elastic, causing them to collapse inward. This also causes the smaller airways supplying them to collapse. Eventually the walls are destroyed. As a result of this, air becomes trapped in the air sacs, and the lungs over-expand with air. This affects the exchange of air in the lungs. COPD patients experience breathlessness, wheezing, chest tightness and a cough (which produces mucus). The most common cause of COPD is cigarette smoke, although inhaling other toxic gases can cause it. Treatment involves smoking cessation, inhaled medication and oxygen therapy in some cases. Unlike Asthma, inhaled medication is not as effective at reversing the airway narrowing in COPD.

Sarcoidosis

Sarcoidosis is a disease that can affect any part of the body, but commonly affects the lungs, eyes and skin. Its cause is unknown, but is thought to occur when the body’s immune system attacks the body’s own cells. The immune system is the body’s defence mechanism, consisting of cells that attack foreign particles and germs. In some cases, these cells organise themselves into groups or clusters, in certain areas of the body to fight infection. In Sarcoidosis of the lungs, these clusters build up in the areas where air is exchanged and impair the transfer of oxygen and carbon dioxide (waste product). They also cause these areas to become swollen. Sarcoidosis patients experience breathlessness, loss of energy, tiredness and a dry cough (does not produce mucus). Some cases of Sarcoidosis are resolved without treatment, but some need steroid therapy to reduce the swelling in the lungs. Other cases get worse over time and the lungs become scarred and more rigid, which prevents them from expanding properly. In Ireland, 1or 2 in 1500 people are affected.

Pulmonary Hypertension

Pulmonary Hypertension is high blood pressure in the pulmonary artery. This is the blood vessel that carries blood with a low amount of oxygen and a high amount of carbon dioxide (waste product) content to the lungs, so oxygen can be added and carbon dioxide released. Narrowing of the artery and its branches causes the high blood pressure. This reduces the movement of blood and impairs the exchange of air. Also, the chamber in the heart that pumps blood to the lungs has to work much harder than normal, and becomes large and swollen, resulting in heart failure. People with Pulmonary Hypertension experience breathlessness, dizziness, swelling of the legs or ankles and tiredness after work or activity. It is a long-term condition. Pulmonary Hypertension has many causes including heart disease, blood clots and lung disease and can be more common within families. Some causes are unknown. Treatment generally involves medication to reduce blood clots, reduce swelling of the limbs and widen the blood vessels. Oxygen therapy may also be used.

Heart Disease

Many diseases of the heart can also affect the function of the lungs. Any heart disease that causes a reduction in the amount of blood supplying the lungs will have an effect on the exchange of air that takes place there. Also, Heart Failure will cause a condition called Pulmonary Oedema, which is a build up of fluid within the lungs. This impairs the exchange of air and also prevents the lungs from expanding properly, consequently reducing the capacity of the lungs. Other heart conditions can cause a build up of fluid between the lungs and the rib cage. This will also reduce the capacity of the lungs.

Sleep Disorders

The most common sleep disorder is Obstructive Sleep Apnoea syndrome (OSAS). Patients with OSAS experience reductions in blood oxygen levels when asleep due to repeated pauses and/or reductions in breathing. OSAS is implicated in a number of instances including hypertension and an increased risk of being involved in a road traffic accident. Other sleep disorders include insomnia and narcolepsy.