Respiratory medicine

Respiratory medicine involves managing a wide range of breathing-related difficulties and lung disorders.

We treat patients for lung disorders including: 

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Lung cancer 
• Pulmonary hypertension
• Pulmonary embolism
• Lung fibrosis 
• Lung infections such as pneumonia and tuberculosis (TB)

Treatment options include lung transplantation at the Mater Hospital.

Rapid access lung clinic (RAC)

The rapid access lung clinic was established at the Mater Hospital in 2011, as part of the national cancer control programme strategy. All patients are offered appointments for outpatient clinic assessment within ten working days of receipt of referral from their doctor where there is a concern of lung cancer.

At the clinic, patients are seen by a lung specialist and nurse coordinator who assess symptoms, perform a clinical examination and decide what diagnostic tests may be required. The lung nurse helps organise and coordinate these tests and is available at the clinic or by phone to discuss what’s involved. Patients most often are evaluated by lung scans, bronchoscopy (internal examination of the lungs using a camera) and breathing tests.

Bronchoscopy

The bronchoscopy unit that opened in 2013. We perform diagnostic procedures for a range of respiratory conditions including lung cancer, infection and inflammatory lung conditions. These procedures include direct airway visualisation, airway wash, bronchoalveolar lavage (BAL), airway brush and various needle and forceps biopsies. We also perform endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) to enable sampling of lesions that sit just outside the main airways. We perform over 500 procedures annually.

National pulmonary hypertension unit

This unit was established in 2003 and is the only centre in Ireland specialising in the evaluation and treatment of pulmonary hypertension. Clinics are held on a weekly basis and are followed by a multidisciplinary team meeting to decide on the most appropriate investigations and treatments.

The unit works in close collaboration with the adult congenital heart disease group and the lung transplant team at the Mater Hospital. We actively participate in clinical trials and seek to have the most up-to-date treatment options available. The unit has a seperate website (www.pulmonaryhypertension.ie) and an active Twitter account (@PHA_Ireland). 

Tuberculosis clinic

The tuberculosis clinic provides care for patients with both active and latent (dormant) tuberculosis, as well as screening for the close contacts of infectious cases. We provide education, diagnostics and treatment with regular clinic follow-up.

Respiratory nurse led service

This service provides care for patients who have a diagnosis of lung disease including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and interstitial lung disease (ILD). We provide support and education on treatments including oxygen, inhalers, nebulisers, home non-invasive ventilators and flutter valves.

We run several respiratory study days as well as short, specific education sessions. Our aim is to raise awareness on respiratory conditions during world COPD, Asthma and ILD days.

Pulmonary laboratory

The pulmonary laboratory performs pulmonary function tests to measure how well your lungs work. They compare lung function with known standards and quantify the effect of impairment from disease or improvement from treatment. Some of the tests include:

• Spirometry
• Reversibility
• Gas transfer
• Lung volumes he-dilution
• Lung volumes plethysmography
• Respiratory muscle strength
• Methacholine challenge
• Mannitol challenge
• Cardiopulmonary exercise tests
• Exercise challenge
• Skin-prick allergy tests
• Impulse oscillometry
• FeNO

Pulmonary rehabilitation programme

Pulmonary rehabilitation is an exercise and wellness programme for patients with COPD. It runs for eight weeks, with participants attending for one hour twice a week. The programme involves individualised exercise programmes and education sessions and are run in line with evidence-based practice.

The classes are coordinated and monitored by the Physiotherapy Department and patients can be referred by respiratory consultants and respiratory clinical nurse specialists. We also work in collaboration with the MedEx program in DCU and refer suitable patients for their twice-weekly program.

Useful links

• National Pulmonary Hypertension Unit Ireland
• Irish Lung Fibrosis Association
• COPD Support Ireland
• Asthma Society of Ireland
• Irish Cancer Society
• Air Liquide
• BOConline Ireland
• Irish Thoracic Society
• NCCP