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Respiratory Medicine 

The Department of Respiratory Medicine at Changi General Hospital, Singapore provides comprehensive care for patients with a wide variety of pulmonary diseases and the critically ill in the Intensive Care Unit.

Our pulmonary and critical care physicians offer consultation, diagnostic and therapeutic services to treat a variety of respiratory and critical care medicine-related conditions, namely lung cancer, Chronic Obstructive Pulmonary Disease (COPD), asthma, sleep-related breathing disorders, acute and chronic respiratory failure, pulmonary infections (e.g. pneumonia), sepsis and septic shock and Acute Respiratory Distress Syndrome (ARDS).

Our department is supported by services in virtually all aspects of ambulatory pulmonary patient care, including a full pulmonary function testing service, complete radiology services, echocardiography, laboratory and sleep medicine services. By integrating clinical expertise, research and education and modern technology, we strive to provide the best medical care and services for patients with pulmonary and critical care needs.

Our doctors are actively involved in ongoing clinical and research work to advance and develop the specialties of pulmonary, critical care and sleep medicine, and they regularly present at national and international scientific meetings related to clinical and basic science investigation in their field. CGH’s Department of Respiratory Medicine is also accredited for the training of basic and advanced specialist trainees in Respiratory Medicine and Intensive Care Medicine.

The Pulmonary and Critical Care clinical services encompass a variety of disease states, including ambulatory pulmonary and sleep medicine, inpatient pulmonary and critical care medicine. The Sleep Medicine Service produces diagnostic and therapeutic interventions for sleep-disordered breathing, such as obstructive sleep apnoea and obesity hypoventilation syndrome. We also treat non-respiratory sleep disorders, such as narcolepsy, insomnia and restless legs syndrome.

DISEASES, DIAGNOSES AND MANAGEMENTS

  • Acute and chronic respiratory failure needing non-invasive ventilation
    We treat this with the management of home oxygen and nocturnal non-invasive ventilation.
  • Asthma and Chronic Obstructive Pulmonary Diseases (COPD)
    • Asthma Clinic
      • Exercise challenge test for exercise-induced asthma
      • Eucapnic voluntary hyperventilation test for exercise-induced asthma
      • Methacholine challenge test for diagnosis of airway hyperreactivity
      • Skin prick test for allergens
      • Exhaled nitric oxide measurement
    • COPD Clinic
      • Spirometry, including diffusion capacity and lung volumes (inspiratory capacity) by plethysmography
      • Six-minute walk test and determination of BODE index (a tool used to predict COPD mortality).
      • Cardiopulmonary exercise test
      • Long-term home oxygen assessment
  • Interventional Pulmonary Services
    • Flexible Bronchoscopy including bronchoalveolar lavage
    • Transbronchial lung biopsy under fluoroscopy
    • Endobronchial ultrasound (EBUS) guided transbronchial needle aspiration
    • Autofluorescence bronchoscopy for assessing early lung cancer
    • Radiological-guided percutaneous biopsy of lung nodule
    • Bronchoscopic foreign body removal
  • Lung Cancer
    • Diagnosis and staging of both non-small cell and small cell lung cancer
    • Diagnosis and staging of mediastinal tumours, e.g. thymoma, lymphoma
    • Assessment for resectability of lung tumours
  • Pulmonary fibrosis
  • Bronchiectasis (non-cystic fibrosis)
  • Pulmonary Rehabilitation Programme (PRP)
    • For patients with chronic respiratory ailments / chronic lung diseases, e.g. COPD, pulmonary fibrosis.
    • Interstitial Lung Disease (Pulmonary fibrosis)
    • Assessment and management of primary (idiopathic) and secondary interstitial lung disease
  • Acute Noninvasive Ventilation (NIV)
    Management of acute NIV for COPD, cardiac failure and other hypercapnic disorders.
  • Pulmonary hypertension and other pulmonary vascular diseases
    Assessment and management of primary and secondary pulmonary hypertension.
  • Respiratory Muscle Disorders
    Septic Shock in the critically ill patient
  • Acute Respiratory Distress Syndrome (ARDS)
  • Pleural Diseases
    • Diagnosis and management of tuberculous (TB) pleural effusions, including pleural biopsy.
    • Malignant pleural effusion, including talc pleurodesis.
    • Primary and secondary pneumothorax (collapsed lung)
    • Outpatient management of pneumothorax using small bore thoracostomy tube and Heimlich valve
    • Thoracic ultrasound service for assessment of pleural effusion and guided chest-drain insertion.
  • Pulmonary Tuberculosis (TB)
  • Chronic Cough
  • Haemoptysis
    Evaluation and emergency treatment of massive haemoptysis (including bronchoscopic intervention and bronchial artery embolisation)
  • Smoking Cessation Clinic
    Run by counsellors and trained pharmacists.
  • Critical Care Medicine
    • Acute Respiratory Distress Syndrome (ARDS)
    • Severe community-acquired pneumonia (CAP)
    • Severe sepsis and septic shock, including neutropenic sepsis
    • Heat exhaustion and heat stroke: body cooling unit for severe heat stroke
    • Continuous extracorporeal blood purification, including continuous renal replacement therapy (CRRT) and plasmapheresis
    • Severe pancreatitis
    • Nutritional management, including parenteral nutrition (intravenous nutrition / feeding)
    • Acute and decompensated chronic liver disease
    • Hypertensive crisis (severe increase in blood pressure that can lead to a stroke, neurological and endocrine emergencies
    • Severe acute poisoning
    • Obstructive Sleep Apnoea (OSA) and other sleep-related breathing disorders.
    • With a full inpatient sleep laboratory service performing diagnostic, CPAP titration, Bi-level titration, MSLT and MWT sleep studies.
    • Management of obesity hypoventilation syndrome (OHS), restless legs syndrome (RLS), narcolepsy, insomnia and other sleep disorders.

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