The Respiratory Medicine and Sleep Disorders service provides general respiratory services to inpatients and outpatients, including respiratory function assessment, fibreoptic bronchoscopy, sleep monitoring, lung oncology as well as clinical management of all respiratory disorders.
The Respiratory Medicine and Sleep Disorders service provides the following services:
- Respiratory function laboratory (including bronchial provocation, cardiopulmonary exercise testing and high altitude simulation test and home oxygen assessment service)
- Fibreoptic bronchoscopy with facilities for endoscopic bronchial ultrasound biopsy (EBUS)
- Overnight oximetry and sleep monitoring (home and hospital based) and sleep disorders clinics
- General respiratory medicine Clinic
- Lung oncology (multidisciplinary) clinic
- Pulmonary hypertension (multidisciplinary) clinic
- Smoking cessation clinic
- Weekly multidisciplinary radiology meetings are available for consultant opinions
RMH sleep service offers a variety of sleep tests including:
- Full in-lab Polysomnography (PSG)- diagnostic/baseline study, treatment review and split studies (incorporating non-invasive therapy and TcCO2 monitoring) as well as Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT). Actigraphy studies can be conducted in conjunction with MSLT/MWT.
- Portable home based sleep studies include - Portable PSG, auto CPAP studies, overnight oximetery, actigraphy and light therapy.
Research initiatives and projects
The Respiratory and Sleep Disorders Medicine Department has a comprehensive research program, which includes:
- Industry-sponsored clinical trials of drugs for the management of asthma, COPD and lung cancer
- Molecular targets involved in the pathogenesis of COPD. This is a collaboration with Associate Professor Gary Anderson from the Cooperative Research Centre for Chronic Inflammatory Diseases, Professor Graham Brown and Dr James Black from the Centre for Clinical Research Excellence in Infectious Diseases, and Dr Caroline Brand, Department Clinical Epidemiology, RMH. This project has involved establishing the Melbourne COPD cohort.
- Investigation of exercise-induced asthma in elite athletes.
- Self-management in acute severe asthma - collaboration with School of Physiotherapy, La Trobe University.
Our current clinical trials include:
- Asthma Clinical Trials
- COPD and Breathlessness Clinical Trials
- Influenza Clinical Trials
- Lung Cancer Clinical Trials
Arterial blood gases
Measures arterial oxygen (PaO2), carbon dioxide (PaCO2), and acidity (pH). Report usually includes carboxy-haemoglobin concentration (COHb%) as an index of recent smoking or inhaled CO exposure.
Bronchial Provocation (Methacholine, Aridol (Mannitol) or Eucapnic Hyperventilation - EVH)
Measure of bronchial reactivity. Useful for assessing possible asthma, if symptoms and signs are equivocal. EVH and Aridol are accepted as a surrogate for exercise induced asthma for elite athletes requiring approved asthma medications.
CO-Diffusion (single-breath technique)
Standard assessment of gas diffusion to assess interstitial lung disease or loss of gas exchanging surface area (e.g. emphysema).
Cycle testing to assess maximal oxygen uptake, maximal exercise capacity or presence of exercise induced asthma. To discuss test format please contact Respiratory Laboratory.
Note: Exercise testing for diagnosis of ischaemic heart disease is performed either in Cardiology or Nuclear Medicine.
Exhaled CO %
Measurement of exhaled carbon monoxide levels.
Hypoxic Altitude Simulation Test
Measurement of cutaneous oxygen saturation or arterial blood gases, breathing specific hypoxic mixture to simulate nominated altitudes.
Incremental walk test or six minute walk
Single-blind assessment of transcutaneous oxygen saturation with patient breathing either air or intranasal oxygen supplementation, during standardised corridor walk. Required to assess eligibility for portable home oxygen.
Maximum inspiratory and expiratory pressures (MIPs and MIPs)
Assessment of respiratory muscle strength.
Rebreathing technique provides approximation of arterial PaCO2. Useful in cooperative patient, if arterial sample unable to be obtained.
Static Lung Volumes (Body Plethysmography)
Measurement of Total Lung Capacity (TLC), Functional Residual Capacity (FRC) and Residual Volume (RV) using either body plethysmograph or inert gas washout techniques.
Measurement of PaO2 before and after 100% oxygen breathing, to assess presence of significant veno-arterial shunting.
Skin Prick Allergy tests
To diagnose the presence of sleep disordered breathing (snoring, obstructive apnea, central apnea and hypopnea), nocturnal hypoventilation, excessive daytime somnolence and other sleep disorders (parasomnia, periodic limb movement, narcolepsy, etc).
Spirometry +/- flow volume loop
Routine testing for Vital Capacity and Forced inspiratory and expiratory flows. Provides first line assessment for airways obstruction, response to bronchodilator, or restrictive conditions.
We accept GP and specialist referrals for this service.
Referrals are triaged depending on priority. Emergency cases can present to the Emergency & Trauma Service at any time.
To refer a patient, complete and send your referral to Outpatients by fax to (03) 9342 4234.
You can use the following form or a template from your own system:
Referrals should include:
- relevant clinical history for the patient
- the reason for referral
- patient details including address, date of birth and contact phone numbers
- your details and provider number
- the name of the consultant (for Medicare clinics)
- if your patient requires ongoing management, please identify the referral as being "indefinite"