Grove City Medical Center News

Grove City Medical Center Enhances Patient Experience Through New Diagnostic Technology

Most people, when faced with a stressful situation, experience several typical physical responses. We begin to sweat. Our hands tremble and we feel a tightening in our stomach. Most unnerving, however, is our sudden inability to breathe normally. Imagine the irony, then, of a medical test designed to measure how efficiently a patient inhales and exhales that actually impairs their ability to do so—because the test itself is so stressful.

Up until recently, about 20 percent of Grove City Medical Center patients whose doctor ordered a test to measure their total lung volume were unable to tolerate the procedure. “It was very frustrating for their physicians,” said Hernan Acevedo, Director of Grove City Medical Center’s Cardiovascular Pulmonary

Services. “In order to determine the source of their patients’ problems, they need to see a clear picture of what is going on, and in many instances, we couldn’t provide that because the patients couldn’t make it through the test.”

Lung volume measurement helps detect restrictive and obstructive lung diseases. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue or by abnormalities of the muscles or skeleton of the chest wall. Chronic obstructive pulmonary disease, or COPD, is a catch-all diagnosis for such common diseases of the lung as bronchitis, asthma or emphysema.

Simply put, people with restrictive lung disease have total impairment of the breathing process, while those with obstructive lung disease have trouble exhaling. What all lung disease patients have in common, however, is the need to undergo regular testing to monitor their lung volumes. “Some patients with severe, complex problems might be ordered by their physicians to go through pulmonary function testing once a year,” said Acevedo.

A person’s lung volume can be measured in several different ways, and two of the more commonly used methods are plethysmography and nitrogen washout. Plethysmography is done with a person seated in a body plethysmograph, a sealed, transparent box that resembles a telephone booth, while breathing in and out through a mouthpiece. Changes in pressure inside the box and mouthpiece allow determination of the lung volume. While the test is precise, some patients experience difficulty interpreting and following the

breathing instructions, which requires them to perform a series of very small panting breaths, or to breathe quickly, slowly or forcefully. Others, who are claustrophobic, cannot tolerate the confinement within the body box.

And there is the anxiety factor. A direct correlation exists between the level of patient compliance and an accurate reading in a pulmonary function test. “The quality of the numbers is completely dependent on whether or not the patient can perform normally,” said Acevedo.

An asthmatic himself with a ‘very restricted airway,’ Acevedo is particularly empathetic with patients who struggle with the body box test. “I can’t stand it,” he said. “When I’m enclosed in a small, confined space, I panic and then I can’t breathe.” His health issues and experiences influenced his career choice; Acevedo is a Registered Respiratory Technologist as well as a Registered Pulmonary Function Technologist.

Now, patients visiting Grove City Medical Center’s Cardiovascular Pulmonary Services Department for a pulmonary function test have a new, more patient-friendly alternative. The hospital has added a pulmonary function machine that will perform the nitrogen washout test. During the nitrogen washout, lung volume is measured when a person breathes a carefully measured amount

of pure oxygen through a tube for a specified period of time. The total amount of oxygen breathed in allows for the estimation of the lung volume.

Patients report that the new test is far less complicated and not at all stressful. “This is a great improvement for our department and our hospital,” said Acevedo. “Technology that enhances the patient experience and produces truer test results for physicians is what medical advancement is all about.”