Pneumology

About the Observatory

The Pneumology Service of the Consorci Sanitari Integral acts as a point of reference for the adult population of the Baix Llobregat Center and Hospitalet Nord, providing specialized attention to pathologies of the respiratory system, with a care model centered on the person.

Presentation The Pneumology Service of the Integral Health Consortium acts as a point of reference for the adult population of the Baix Llobregat Center and Hospitalet Nord, providing specialized attention to pathologies of the respiratory system, with a care model centered on the person. This ranges from acute processes that require hospitalization to care for chronicity, through the ambulatory study of complex processes that require highly specialized treatments (biological drugs, home respiratory therapy devices...)

Throughout this process, we work in collaboration with the different healthcare facilities in our area

The Pneumology Service has monographic consultations and/or Day Hospital for the care of the most complex patients. However, the need for a multidisciplinary approach has led to the creation of working groups in which the Pneumologists work together with other professionals from the Consortium, Primary Care and/or the Bellvitge University Hospital

Specialized ambulatory care is provided by Pneumologists from the Service who visit the Specialized Care Centers (CAE) in Ronda la Torrassa, Cornellà de Llobregat and Sant Feliu de Llobregat. In these centers, visits derived from Primary Care are made to solve the most prevalent respiratory pathologies or the patient is referred to the most convenient device depending on the basic pathology. Collaboration with A. Primary through regular meetings (face-to-face or online) and virtual consultation.

  • Update date: 11/05/2023

Units and benefits

Hospitalization

Patients who require diagnosis and/or inpatient treatment for acute respiratory pathology or for exacerbation of a chronic respiratory process (with or without respiratory insufficiency). Includes 6 beds with monitoring for observation of patients in serious condition and application of non-invasive respiratory support therapies.

 

  2019 2020 2021
Old one 770 825 1051
Outpatient activity
  • Day Hospital:
    • Continued attention to severe chronicity, both in stable phase and exacerbations.
    • Control of patients treated with: home oxygen, nebulized antibiotics, alpha1-antitrypsin iv, immunoglobulins iv and biological asthma drugs.
    • Diagnostic and/or therapeutic pleural thoracentesis guided by ultrasound
  • General external consultations at the CAE: Ronda Torrassa (l'Hospitalet), Cornellà and Sant Feliu de Llobregat
  • Monographic inquiries:
    • Interstitial Pulmonary Diseases
    • Monitoring patients with continuous positive airway pressure (CPAP)
    • Allergic asthma
    • difficult-to-control asthma
    • Pulmonary hypertension
    • Pulmonary Tuberculosis
    • Lung cancer
    • PneumoCOVID: Follow-up of patients who have required admission for severe SARS-CoV-2 pneumonia
    • Smoking cessation consultation

 

Specialized units
  • Multidisciplinary Sleep Disorders Unit.
  • Tuberculosis Unit, accredited as a specialized unit by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR).
  • Lung Cancer Rapid Diagnosis Unit.
  • Smoking Unit. Accredited as a basic unit by SEPAR. Led by expert nurses, it treats both inpatients and outpatients
  • Bronchiectasis Unit for the management of patients with chronic bronchial infection who may or may not need nebulized antibiotic treatment

 

Cabinets - Respiratory endoscopy:
  •  Fibrobronchoscopy with obtaining diagnostic samples:
    • Bronchoaspirate for cytological, microbiological study
    • Protected or conventional alveolar lavage: cellularity, microbiology and immunological studies
    • Bronchial curettage for cytological study
    • Back protected by microbiological study
    • Bronchial biopsy
    • Transbronchial lung biopsy
    • Puncture of mediastinal adenopathies
  • Closed pleural biopsy
Cabinets - Pulmonary functionalism:
  • Spirometry with or without bronchodilator test
  • Study of static lung volumes by plethysmography and Helium
  • Study of pulmonary diffusion in CO
  • Measurement of muscle pressures (PIM and PEM)
  • Study of the upper respiratory tract
  • Spirometry lying/standing
  • Determination of nitric oxide in exhaled air
  • Nonspecific bronchial provocation tests (methacholine test)
  • Six-minute walking test (walking test) basal and with oxygen
  • Respiratory allergy study: Prick test

 

Cabinets - Sleep testing cabinet
  • Respiratory polysomnography
  • Polygraphs, outpatient and inpatient
  • CPAP qualifications, outpatient and inpatient
  • Split-night study
  • Nocturnal pulse oximetry at home (basal, with Oxygen and/or with CPAP/BiPAP)
Tests that are referred to other centers:
  • Bronchial echoendoscopy (EBUS)
  • Rigid bronchoscopy
  • Positron Emission Tomography (PET)
  • Pulmonary scintigraphy
  • Bronchial arteriography with or without arterial embolization
  • Right heart catheterization
Participation in Commissions and Working Groups:
  • CSI Mortality Commission
  • CSI Care Ethics Commission
  • CSI Lung Cancer Committee
  • CSI Multidisciplinary Working Group on Sleep Disorders
  • CSI Bariatric Surgery Committee
  • Territorial sessions of the CSI chronicity area
  • CEIC HU Bellvitge
  • South Metropolitan Area Tuberculosis Working Group
  • Commission for Harmonization of the pharmacological treatment of COVID-19 (CatSalut)
  • Update date: 11/05/2023

Diseases and procedures

  • Chronic Obstructive Pulmonary Disease (COPD)

    Lung disease related to tobacco consumption. It is a chronic and progressive disease. Approximately 25% of smokers will develop COPD. Its onset is insidious with non-specific symptoms such as cough, expectoration and acute bronchitis which are given little importance. This means that it takes time to diagnose it and it is usually done in phases when the respiratory capacity is already significantly affected. Its main symptom is dyspnea (shortness of breath) on exertion. The only action that stops the progress of the disease is to stop smoking. The main treatment is inhaled bronchodilator drugs, which improve symptoms. When the pulmonary function is very impaired, respiratory failure may appear and treatment with oxygen at home must be instituted. It is often associated with other diseases (comorbidities).
    of a cardiovascular nature (often linked to the same risk factor, tobacco), but also a consequence of the decrease in physical activity due to suffocation (obesity, loss of muscle strength, osteoporosis) and affectation of the psychosocial sphere ( depression, anxiety, social isolation). In the advanced stages they usually require urgent care/admission and follow-up visits. All together conditions great burdens on the family environment. The millet approach is preventive with the promotion of healthy lifestyle habits.

  • Asthma

    Chronic inflammatory disease of the respiratory tract, conditioned in part by genetic factors, which causes narrowing of the bronchi in response to various stimuli (allergy, pollution, viral infections and some drugs such as anti-inflammatory drugs). The prevalence varies depending on age, sex and geographic location. The treatment is preferably with anti-inflammatory drugs and inhaled bronchodilators with the aim of maintaining control of the disease (symptoms and lung function) as well as preventing exacerbations, which can put the patient's life at risk
    Adherence to treatment is key to achieving control. Patients who do the treatment at high doses and do not succeed
    Controlling the disease should be evaluated at a specialist consultation

  • Lung cancer

    It is the first cause of death from cancer and its frequency is increasing in both men and women.
    Largely related to tobacco. It is caused by disordered growth of the cells of the bronchial mucosa.
    It is the second most common cancer in men and the fourth in women. It is the cancer with the highest mortality rate, but with the therapeutic advances of recent years, it is expected to be chronic. The best approach, however, is still to quit smoking and have healthy lifestyle habits.

  • Interstitial Lung Diseases (ILD)

    Heterogeneous group of chronic diseases that are characterized by being infrequent,
    difficult to diagnose and often require complex treatments. In all these diseases, the lung tissue is damaged (with or without a known cause) and does not heal well, with scars appearing that gradually replace the healthy tissue. As a result, there is a loss of lung function. According to the cause they can be classified into:

    • Idiopathic fibrosis: no known cause.
      • idiopathic pulmonary fibrosis (IPF)
      • Idiopathic fibrosing non-specific interstitial pneumonia.
    • Fibrosis of known cause or associated with other diseases:
      • Chronic hypersensitivity pneumonitis
      • Pneumoconiosis by inhalation of particles
      • Non-specific fibrosing interstitial pneumonia associated with autoimmune diseases
      • Pneumonitis induced by drugs or radiotherapy

    The symptoms are irritative cough and suffocation on exertion. In the forms associated with other diseases we will also find the
    symptoms specific to these (arthritis, skin lesions...).

  • Sleep Apnea (SAHS)

    It is a disorder in which breathing is interrupted in whole or in part repeatedly during sleep. It affects 2-5% of the general population and is more common in men. Often associated with obesity.
    Its consequences derive from:

    • The low quality of sleep that is light and fragmented: sleepiness during the day, lack of concentration, memory problems...)
    • The efforts of the inspiratory muscles to reopen the airway, associated with tissue deoxygenation/reoxygenation phenomena, causes cardiac work overload, arterial hypertension and pulmonary hypertension

    It is proven that SAHS is an independent risk factor for the occurrence of cardiovascular disease (mainly hypertension, stroke, arrhythmia and heart failure. It is also associated with a greater risk of suffering traffic accidents)

  • Update date: 11/05/2023

Research

The service participates in multicentre studies in the areas of tuberculosis, pulmonary fibrosis, tobacco, bronchiectasis, asthma and chronic obstructive pulmonary disease (COPD).

  • Update date: 11/05/2023

Teaching

  • The service participates in the undergraduate training of 4th year Medicine students of the UB-Clinical Campus with two associate professors and two teaching collaborators
  • He also participates in the postgraduate training of internal resident doctors (MIR) in Family Medicine, Internal Medicine, Geriatrics and Anesthesia with a tutor and two teaching collaborators
  • Periodically organizes a shared conference with Internal Medicine and Primary Medicine on chronic lung disease
  • It organizes a biannual conference on lung cancer updates
  • Participates in the organization of pulmonary nursing courses
  • Update date: 11/05/2023