The Division of Paediatric Pulmonary Medicine and Sleep provides comprehensive care to patients from the newborn period, childhood, through adolescence and young adulthood. We manage the whole range of disorders of the respiratory system, providing state-of-the-art diagnostic, intervention and management in a timely manner. We see children with various presentations of respiratory disease, and offer evaluation of children with the following symptoms:
- Asthma
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Allergic rhinitis
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Pneumonia
- Other respiratory tract infections such as bronchiolitis
- Pleural diseases
- Chronic lung diseases such as childhood interstitial lung disease, bronchiectasis, cystic fibrosis, and bronchopulmonary dysplasia (BPD)
- Immunodeficiency manifesting with frequent chest infections (in conjunction with our immunology colleagues)
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Neuromuscular disorders
- Lung aspiration syndromes, including swallowing abnormalities
- Children with home ventilation requirements
- Chest wall deformities
- Congenital abnormalities of the airways and lungs
- Sleep-related breathing disorders (such as obstructive sleep apnoea - OSA) and common behavioural sleep problems
- Other diseases with lung involvement
Lung Function and Allergy Testing
We provide a wide range of diagnostic services including a lung function laboratory offering various tests to diagnose childhood respiratory conditions. These include spirometry, lung volumes, diffusion capacity, exercise stress testing and exhaled nitric oxide evaluation. We also have facilities for lung function assessment in preschool children using impedance oscillometry. As allergy is an integral part of asthma, we also offer tests for allergy, such as skin prick testing and in-vitro blood testing if required, as part of the evaluation of the allergic child.
Paediatric Fibreoptic Bronchoscopy Service
We provide a paediatric flexible fibreoptic bronchoscopy service, including broncho-alveolar lavage, for all age groups ranging from newborns to adolescent patients. This is a procedure that allows us to closely evaluate the lungs and airways, obtain samples for further investigation, and treat certain airway and lung conditions. Most procedures can be performed under sedation without the need for general anaesthesia.
Chronic Pulmonary Disease
We manage a wide range of chronic lung disorders including and not limited to bronchiectasis, childhood interstitial lung diseases, bronchopulmonary dysplasia and cystic fibrosis.
A full range of lung function tests, radiological and pathological facilities are available for diagnosis and evaluation. Sweat testing by pilocarpine iontophoresis for the screening of cystic fibrosis is also available in our centre.
We work closely with our physiotherapists, occupational therapists, nutritionists, social workers and other paramedical staff to provide long-term holistic care for children with chronic respiratory disorders.
Multidisciplinary Clinics
Neuromuscular clinic
We have multidisciplinary clinics for children with
neuromuscular disorders. Patients see the paediatrician specialising in pulmonary medicine and sleep along with other specialists in the same clinic session to minimise the number of trips that they need to make to the hospital. Our team closely monitors the patient's respiratory status, and provides care for any respiratory complications that may arise from the patient's underlying condition. For the management of more advanced diseases, we provide home respiratory support care and home ventilation services.
Aero-Digestive Service
Children with swallowing disorders may present with feeding problems and/or recurrent or chronic lung disease due to recurrent aspiration into the airways and lungs.
We provide clinical evaluation of patients who are suspected to have these difficulties in our aero-digestive clinic. The evaluation is made through a multidisciplinary approach together with paediatricians specialising in gastroenterology, nutrition, hepatology and liver transplantation, dietitians and swallowing specialists. The evaluation may involve diagnostic tests such as laryngoscopy or bronchoscopy, FEES (fibreoptic endoscopic evaluation of swallowing) and videofluoroscopy. After a diagnosis has been made, the patient can then be managed and followed-up appropriately.
We also provide ongoing assessment and rehabilitation for children who have undergone tracheostomy insertion, including training for speech and vocalisation.
Sleep and Airway Clinic
Children with complex sleep related problems are seen in our sleep and airway clinic. They will be taken care of by a team of specialists who run these clinics, including paediatric pulmonologists, ENT surgeons, developmental paediatricians and paediatric sleep psychologists.
We offer screening and diagnostic services for patients with suspected obstructive sleep apnoea and other sleep-related breathing disorders which can manifest as symptoms such as excessive daytime sleepiness and snoring.
We also see children with common behavioural sleep problems such as night-wakings, night-time fears, and other bedtime problems such as bedtime resistance.