Services, Tests and Procedures

Lung Function Testing

Lung function tests (LFTs) are essential to complete a respiratory assessment. LFTs assist respiratory condition diagnosis and monitor their progression by assessing how well the lungs work. The main testing method is spirometry, which involves breathing through a mouthpiece and blowing as hard as you can and holding your breath. This helps us understand how much or how quickly you can move the air in and out of your lungs, while alternative tests assess how well gases move between your lungs and your bloodstream.

Spirometry

Measures both maximal inspiratory and expiratory volume. It is typically conducted before and after administering a bronchodilator (salbutamol).

Fraction of exhaled nitric oxide (FeNO)

Measures the amount of nitric oxide exhaled, which is an indicator of eosinophilic airways inflammation. It can be used to assist both diagnosis and management of eosinophilic asthma.

Diffusion capacity of carbon monoxide (DLCO

Measures how well gas transfers between the lungs and the pulmonary vascular system. Used primarily to assess pathologies affecting the lungs parenchyma and pulmonary vascular system.

Body Plethysmography

Measures various volumes of the lungs (e.g. deadspace). Useful in assessing the precise cause of restriction seen during spirometry.

Bronchoprovocation test

Measures spirometry after exposure to increasing dosages of mannitol, which dries the airways. Spirometry is performed after each dose. A decline in FEV1 by 15% is considered a positive test.

Maximal inspiratory and expiratory pressures

Measures the maximal efforts of the respiratory muscles. Typically used to assess for neuromuscular dysfunction.

General Instructions for Lung Function Testing

What to bring

Referral letter: if your referral has not been sent via the provided methods (listed on our Referrals and Appointments page), please bring a hard copy.
Medication list: Bring a complete list of your medications. If you do not have a list, bring all of your medications, especially inhalers or puffers.
CPAP Device: If you use a CPAP machine, please bring it to your appointment.
Mask: If you have cold or flu-like symptoms, wear a mask to your appointment. Masks are available at Gleeson House reception if needed.

What to expect and wear

Testing details: Lung function testing involves a series of vigorous assessments of the various aspects of your lung function. The specific tests performed will depend on your referral and medical needs.
Clothing: Wear loose-fitting, comfortable clothing to allow ease of movement during testing.

For More Information

For more information, see linked instructions below.

Full Lung Function Testing Spirometry +/- FeNo Mannitol Bronchochallenge

Tests and Procedures Performed by Dr. Feng

Dr. Feng is highly skilled at performing a broad range of procedures in Respiratory Medicine. All procedures require hospital admission in some capacity.

Dr. Feng currently conducts these procedures primarily at Calvary Lenah Valley, with occasional exceptions for ultrasound-guided and pleural procedures (excluding bronchoscopy). Requests for this special consideration must come from the treating clinician and are subject to Dr. Feng’s discretion. Exceptions must be made at the request of the treating clinician and at Dr. Feng’s discretion. Alternative locations for these procedures include Calvary St. John’s or Hobart Private Hospital.

If you do not have Private Health Insurance and require a procedure, Dr. Feng will assist in coordinating your care with the Royal Hobart Hospital or another service provider.

Thoracic Ultrasound

Dr. Feng may use a point-of-care ultrasound to examine your chest. This facilitates a detailed assessment of the pleura and lungs, aiding in decision-making and treatment planning. The ultrasound assessment is bulk billed.

Bronchoscopy

A bronchoscopy involves using a thin, fibre-optic camera to examine the airways (breathing tubes) of your lungs. Typically performed under sedation, this procedure can collect samples from the airways and, in some circumstances, lung tissue.

Linear EBUS

Linear Endobronchial Ultrasound (EBUS) is similar to a bronchoscopy but includes a small ultrasound machine at the end of the bronchoscope. This allows for visualisation and biopsy of structures outside of the airways and is primarily used for biopsying lymph nodes.

Linear EUS/EUS-B

Linear Endoscopic Ultrasound (EUS) or EUS with a bronchoscope (EUS-B) uses a gastroscope or bronchoscope with an ultrasound machine located near the end of the scope. This procedure is designed for visualisation and biopsy of structures outside the oesophagus. Some structures within the chest are better accessed with EUS/EUS-B rather than EBUS, and vice versa.

Radial EBUS

Radial EBUS involves passing a slim ultrasound probe through a bronchoscope and is primarily used to locate lung nodules that are beyond the reach of a bronchoscope.

Intercostal Catheter Insertion and Talc Slurry Pleurodesis

Intercostal Catheter Insertion: A plastic tube is placed into the pleura (chest lining) to drain fluid or air. This bedside procedure is typically done using local anaesthetic.

Talc Slurry Pleurodesis: A sterile talc slurry (medical grade talcum powder mixed with saline) may be instilled into the pleural space via the intercostal catheter. This technique helps the lung adhere to the chest wall, preventing the recurrence of fluid and/or air.

Thoracocentesis

Thoracocentesis involves draining fluid from the pleural space, either with an intercostal catheter or aspirating it with a needle and syringe. This procedure is generally performed with local anaesthetic only.

Pleural Biopsy

A pleural biopsy uses a core-biopsy needle to obtain a sample from the chest-wall lining (parietal pleura). Dr. Feng performs this procedure with real-time ultrasound guidance to ensure biopsy precision.

Ultrasound-guided lung biopsy

This procedure is similar to a pleural biopsy but the biopsy is taken from lung tissue itself. This can only be performed on conditions which have some interface with the outer lining of the lung (visceral pleura).

Indwelling Pleural Catheter Insertion

An indwelling pleural catheter is a more permanent version of an intercostal catheter. This procedure is primarily used to treat pleural fluid build-up associated with cancer.

Supraclavicular lymph node biopsy

Dr. Feng is skilled in biopsying lymph nodes in the supraclavicular fossa (above the collarbone). The bedside procedure is performed under local anaesthetic.

Other ultrasound-guided biopsies/procedures

Through extensive training, Dr. Feng has developed expertise in performing a wide range of ultrasound guided biopsies and procedures. For extra-thoracic (outside of the chest) procedures, a specialist medical practitioner referral is required before consideration.

Specialist Respiratory Consultation