Kwong Wah Hospital Hospital Authority
Respiratory Medicine

Introduction

Like many of its neighboring countries, Hong Kong undoubtedly suffers from serious air pollution problem. Combined with a low public awareness of infectious and occupational disease and unhealthy habits particularly smoking have increased risks of respiratory diseases, such as asthma, chronic obstructive pulmonary disease, tuberculosis and lung cancer. However, respiratory diseases are not limited to those mentioned above. An affluent yet stressful and sedentary lifestyle, along with the rising incidence of obesity, have led to increasing prevalence of obstructive sleep apnoea. It is well established that respiratory diseases rank top among common diseases in Hong Kong.


In view of this, Kwong Wah Hospital set up a highly specialised respiratory team within the Medicine and Geriatrics Unit , bringing together experienced respiratory physicians, nurses, physiotherapists and occupational therapists to improve patient care. Equipped with state-of-the-art healthcare facilities and regularly updated knowledge, they offer a full range of respiratory medical services of high diversity and quality with in/out-patient departments, the Respiratory Medicine Centre as well as the Day Hospital.

Professional Services

1. In-patient Services:
At the Medicine and Geriatrics Unit of KWH, there are a total of 17 beds dedicated to patients in respiratory medicine, mainly those admitted through A&E Department or those requiring further hospitalized treatment after clinical diagnosis. Invasive, as well as non-invasive ventilator-assisted therapy and high dependency unit services are provided there.

2. Out-patient Services:
Specialized out-patient services in respiratory medicine are available at the Medicine and Geriatrics Unit of KWH every week, headed by experienced specialists.

3. Respiratory Medicine Centre Services:
The Respiratory Medicine Centre is the main department responsible for planning, promoting and enhancing specialist respiratory medical services at the Medicine and Geriatrics Unit . Regular services include:

3.1 Pulmonary Function Test: Test items include:
1. Lung Capacity, Diffusing Capacity of the Lung for Carbon Monoxide and Lung Plethysmography
2. Portable Spirometry

3. Airway Resistance Test
Suitable for children, elderly people and patients who cannot undergo ordinary pulmonary function test. Patients only have to breathe naturally during the test without overventilation.
4. Cardiopulmonary Exercise Testing
Patients’ response to exercise stress is assessed in a safe and monitored setting, where data such as oxygen/carbon dioxide exchange, electrocardiogram, blood oxygen level and pressure are analysed in order to identify the causes of exercise impairment, evaluate the risk of surgery and draw up an exercise training plan. Data from pulmonary function test can facilitate correct diagnosis and treatment for the respiratory disease concerned.

3.2 Sleep Test:
Mainly used for the diagnosis of obstructive sleep apnoea.

3.3 Positive Pressure Ventilator Titration Test:
Test for the severity of sleep apnoea to help doctors design the appropriate treatment plan for patients with obstructive sleep apnoea.

3.4 Continuous Blood Oxygen Monitoring:
24-hour monitoring of patients’ blood oxygen level to evaluate the treatment efficacy and progress of respiratory patients.


3.5 Endoscopy:
1. Fiberoptic Bronchoscopy and Endoscopic Ultrasound:
Fiberoptic bronchoscopy allows direct visualisation of the bronchi and biopsy for testing; if lymph nodes are found outside the bronchi, endoscopic ultrasound can guide a fine needle to obtain tissue and determine the type of tumour for early, suitable treatment.
2. Thoracoscopy:
Thoracosopy allows direct visualization and biopsy for testing; for patients with recurrent pneumothorax or pleural effusion due to lung cancer, the procedure enables doctors to administer localized drugs directly into the pleural cavity, perform pleural adhesiolysis or other treatments.

3.6 Health Education for Respiratory Patients:
Various education talks are organised to raise patients’ awareness of diseases and seek their cooperation to bring the conditions under control. Health education talks provided by the Respiratory Centre for respiratory patients include:

1. Talks on Respiratory Diseases – patients are informed about their respiratory diseases to enhance their self-care capacity.

2. Talks on Drugs/Equipment – patients are taught to use different respiratory drugs and equipment properly; accuracy and compliance in medication-taking is promoted to improve treatment efficacy.

3. Smoking Cessation Talks – patients are encouraged and appropriate assistance provided to quit smoking.

4. Day Hospital Services:
The Respiratory Medicine Centre is the main department responsible for planning, promoting and enhancing specialist respiratory medicine services at the Medicine and Geriatrics Unit of KWH. Recurrent services include:

4.1 Respiratory Oncology Out-patient Clinic:
The Respiratory Oncology Out-patient Clinic was established by the Medicine and Geriatrics Unit of KWH in November 2010 to receive internal referrals for patients diagnosed with lung cancer who are suitable for targeted therapy.

4.2 Out-patient Consulation
To facilitate efficient patient care, our respiratory team receives internal consultations from out-patient clinics to expedite diagnosis and management. Referrals will be seen in our Ambulatory Medical Service centre on a weekly basis.