Respiratory Medicine

The Institute of Respiratory Medicine provides focused care through specialised areas designed to address different respiratory conditions and levels of complexity.

Asthma and Allergic Disorders

Asthma and allergies frequently affect the airways together. Exposure to allergens such as dust mites, pollen, mould, animal dander, pollution or occupational substances may trigger or worsen respiratory symptoms in susceptible individuals.

The Asthma and Allergic Disorders service focuses on evaluating the pattern, severity and triggers of symptoms so that treatment can be tailored to the individual patient.

Assessment and management may include:

• Spirometry and lung-function assessment

• Peak-flow monitoring

• Allergy evaluation

• Assessment of environmental and occupational triggers

• Inhaler therapy

• Nebulisation when clinically required

• Allergy-control strategies

• Patient education on correct inhaler technique

• Immunotherapy in selected patients

• Biologic therapy for appropriately selected severe asthma patients

• Long-term monitoring of asthma control

Respiratory specialists also assess patients whose asthma remains uncontrolled despite regular treatment or who experience recurrent exacerbations.

Interventional Pulmonology

Interventional Pulmonology uses specialised minimally invasive procedures to evaluate and manage diseases affecting the lungs, airways and pleura.

These procedures may help obtain tissue or fluid samples, investigate abnormal imaging findings, evaluate airway obstruction or provide treatment in selected respiratory conditions.

Interventional Pulmonology Procedures

Depending on the patient's condition, procedures may include:

• Flexible bronchoscopy

• Rigid bronchoscopy

• Endobronchial ultrasound (EBUS)

• Bronchoscopic biopsy

• Lung biopsy procedures

• Thoracoscopy or pleuroscopy

• Thoracentesis

• Pleural drainage

• Airway stenting

• Management of airway narrowing

• Foreign-body removal

• Selected procedures for airway tumours

• Management of pleural effusion

• Procedures for pneumothorax

Bronchoscopy enables doctors to examine the airways directly using a thin flexible or rigid instrument. It can also be used to collect tissue, fluid or other samples for laboratory examination.

Endobronchial ultrasound (EBUS) combines bronchoscopy with ultrasound to assess structures and lymph nodes within the chest. It can assist in diagnosing conditions such as lung cancer, infections and other abnormalities without requiring more invasive surgical procedures in suitable cases.

The appropriate procedure is selected after reviewing the patient's symptoms, imaging results and overall medical condition.

Critical Care Medicine

Some respiratory illnesses can become severe enough to require continuous monitoring, advanced oxygen therapy or intensive care.

Respiratory and critical care specialists work together to manage patients with serious breathing problems and other life-threatening conditions.

Respiratory conditions requiring critical care may include:

• Acute respiratory failure

• Acute respiratory distress syndrome (ARDS)

• Severe pneumonia

• Severe COPD exacerbations

• Life-threatening asthma attacks

• Severe pulmonary infections

• Sepsis associated with respiratory infection

• Airway emergencies

• Complications of chronic lung disease

• Severe hypoxaemia or low blood oxygen

• Patients requiring mechanical ventilation

Respiratory support may include conventional oxygen therapy, high-flow oxygen therapy, non-invasive ventilation such as CPAP or BiPAP and mechanical ventilation when clinically required.

Patients recovering from prolonged respiratory illness or intensive care may also require respiratory physiotherapy, rehabilitation and carefully monitored weaning from ventilatory support.

Respiratory Diagnostic Services

Accurate diagnosis is essential because cough, wheezing and breathlessness can occur in several different medical conditions.

Evaluation typically begins with a detailed medical history, physical examination and assessment of oxygen levels.

Depending on the suspected condition, diagnostic investigations may include:

Pulmonary Function Tests

Pulmonary function testing helps assess how effectively the lungs move air and may help identify conditions such as asthma, COPD and restrictive lung diseases.

Spirometry

Spirometry measures the amount of air a person can breathe in and out and how quickly air can be expelled from the lungs. It is commonly used for diagnosing and monitoring asthma and COPD.

Chest X-Ray and CT Imaging

Imaging can help identify pneumonia, lung nodules, pleural disease, pulmonary fibrosis, bronchiectasis and other structural abnormalities.

Bronchoscopy

Bronchoscopy allows specialists to examine the airways and, where needed, obtain samples for diagnosis.

Endobronchial Ultrasound

EBUS provides additional imaging from within the airways and may help evaluate lymph nodes or abnormalities within the chest.

Sputum and Laboratory Testing

Sputum and blood investigations can help identify infection, tuberculosis, inflammation, allergic conditions and other causes of respiratory symptoms.

Oxygen Assessment and Arterial Blood Gas Analysis

These tests evaluate oxygen and carbon dioxide levels and are particularly important in patients with severe respiratory disease or suspected respiratory failure.

Sleep Studies

Polysomnography and other sleep assessments may be recommended for patients with suspected obstructive sleep apnoea or other sleep-related breathing disorders.

Exercise and Functional Assessment

Tests such as the six-minute walk test can help evaluate exercise capacity, breathing difficulty and changes in oxygen levels during activity.

Respiratory Medicine Treatment and Care

Treatment is selected according to the diagnosis, disease severity, lung function, oxygen levels, associated medical conditions and individual patient requirements.

Respiratory care may include:

• Inhalers and bronchodilator medicines

• Inhaled anti-inflammatory treatment

• Nebulisation

• Antibiotic or antiviral treatment when appropriate

• Anti-tubercular treatment

• Allergy-management strategies

• Oxygen therapy

• CPAP or BiPAP

• Pulmonary rehabilitation

• Respiratory physiotherapy

• Smoking-cessation support

• Vaccination guidance

• Bronchoscopic and pleural procedures

• Critical respiratory care

• Long-term monitoring of chronic respiratory disease

For chronic conditions such as asthma, COPD, bronchiectasis, pulmonary fibrosis and interstitial lung disease, regular follow-up helps doctors assess symptoms, lung function, response to treatment and changes in disease over time.