The Department of Critical Care Medicine (Intensive Care Medicine) and Pulmonary (Respiratory or Chest) Medicine aims to provide comprehensive care, for even the most complex cases. Our faculty are one of the most experienced in these fields, and have a record of excellence in clinical Pulmonology and Critical Care, including specialty areas such as Interventional Pulmonology, which is not common in India.
Treatment & Services
- Critical care/ICU services
- Respiratory care
- Interventional Pulmonology
Our overall approach is to foster an environment where we combine expertise, information, communication and support to help the patient in the treatment of these disorders and the family with the difficult times which come with critical illness and chest disorders. We understand the crisis which descends on individuals and families in these times, and try as both professionals and individuals to be with you through these challenging periods.
- Our Pulmonary services covers the entire spectrum of Respiratory Care and Chest Medicine, ranging from lung disease prevention and detection to pharmacologic and interventional treatment. We have specialized Pulmonary medicine expertise with the most sophisticated techniques and technologies available to diagnose and treat many patients with chest and respiratory problems. The disease spectrum includes the following:
- Airway Disorders such as Asthma, Bronchitis, COPD, and Bronchiectesis. The incidence of asthma, bronchitis, chronic cough, and recurrent respiratory infections and other airway disorders is on the rise in India in general, and urban cities in particular. We are a specialized center for preventive, educational and treatment aspects of asthma, COPD and other airway disorders and provide comprehensive services to take care of these patients.
- Pleural diseases such as pleural effusion and pneumothorax
- Interstitial Lung Disease (ILD), including Sarcoidosis and IPF
- Pulmonary Vascular disease, including Pulmonary Hypertension, Pulmonary embolism and others
- Lung Cancer, and other forms of cancer which affects the lungs
- Shortness of breath due to any cause
- Peri-operative care of patients with lung disease.
- Respiratory care of Neuromuscular disease such as motor neuron disease, kyphoscoliosis and so on
- Smoking related lung disorders and smoking prevention.
- Interventional Pulmonology: A unique specialty by itself
- Sleep Disorders including Obstructive Sleep Apnea
- Lung transplant and care
- We provide expertise in diagnosis and management of diseases such as obstructive sleep apnea, and other sleep disorders such as narcolepsy, restless leg syndrome, and insomnia. These disorders play a major role to hypertension, cardiovascular disease, congestive heart failure, diabetes and stroke, and are strongly under diagnosed and untreated due to lack of knowledge and expertise
- INTERVENTIONAL PULMONOLOGY is a new State-of the-art field within Pulmonary medicine that focuses on the use of advanced diagnostic and therapeutic techniques to treat patients with benign airway disorders, pleural diseases, Interstitial lung disease and lung cancer. These complex procedures include both diagnostic and advanced therapeutic interventions and are at the cutting edge of both diagnostic and therapeutic bronchoscopy and thoracoscopy. We are a specialized center for Interventional Pulmonology, and there are very few institutions in the country, which can offer comprehensive services in Interventional Pulmonology
- Transbronchial needle aspiration and Biopsy
- Endobronchial Ultrasound (EBUS) guided transbronchial needle aspiration and biopsy
- Transbronchial biopsy for diagnosis of diseases such as TB, sarcoidosis, and lung cancer
- Rigid bronchoscopy
- Thermal ablation in the airway: Electrocautery, argon photocoagulation, Cryotherapy
- Airway Stent placement
- Medical Thoracoscopy, diagnostic and therapeutic.
- Pleurodesis for recurrent effusions as in cancer and some benign disorders.
- Expert management of Broncho-pleural fistula using endoscopic techniques
- Percutaneous tracheostomy: This involves tracheostomy at the bedside, in critically ill patients, avoiding surgical dissection, and is the preferred procedure for tracheostomy in intensive care units worldwide.
Our Partners in Chest Disease – The Department of Thoracic Surgery. We have special expertise in Thoracic surgery, with experienced personnel who can do complex chest surgeries using the latest endoscopic techniques, such as VATS (Video-assisted thoracic surgery).
- VATS decortication
- VATS lobectomy
- VATS bullectomy
- VATS sympathectomy for hyperhidrosis
- Tracheal surgery
This has led to the formation of a specialized center, as detailed below.
Center for Airway Disorders
We specialize in the treatment of airway disorders such as tracheal and bronchial stenosis, endobronchial ablation of tumours, airway-recanalizing procedures such as balloon bronchoplasty, and airway stenting.We are also specialized in the treatment of broncho-pleural fistula, using unique and innovative endoscopic methods. Other specialized areas include the treatment of Tuberculous bronchostenosis, a complex condition which causes loss of lung function due to airway narrowing in tuberculosis. This is best done by our interdisciplinary team, including Interventional Pulmonology and Thoracic Surgery who work in collaboration to optimize outcomes.
Critical Care Medicine (Intensive Care Medicine or ICU Medicine), with a focus on standardized care, and specialty Respiratory Critical Care Medicine ICU medicine has assumed an exponential need and tremendous importance in India with increasing intensity of illness, and has been met by the rapid progress of knowledge, skills, and technology in the field. As per one study, every human being will have at least 1.7 trips to the ICU in a lifetime. Traditionally, through the inception and development of ICU care, the focus has been on proactive intervention, rapid stabilization, and careful monitoring in a high-tech environment. With progress in technology and life-support, ICU care has assumed qualities not commonly seen earlier: more complexity, longer stays, more secondary events, and more complications and infections. Care in the ICU is expensive, due to the need for infrastructure, equipment, and skilled personnel, adding multiple economic pressures to this equation. With this background, the average mortality in most modern ICU’s still approaches 50%. In such a situation, ICU physicians assume much more than just the role of an intensiv¬ist tiding over critical illness in a high-tech environment. It is incumbent on ICU physicians to maintain a thorough knowledge of new developments and technologies, with proven outcomes data, and to apply each one proactively when caring for the critically ill patient. They also need to see the larger perspective of long-term outcomes in order to prevent complications related to treatments used in the ICU setting. The thrust is not only the immediate stabilization of critically ill patients, but also the planning and institution of measures that will favorably influence the ultimate outcomes.In Aster CMI, we offer such a standardized approach, to favorably impact on outcomes in critically ill patients. In addition, specialty areas of ICU care, such as Respiratory Critical Care is the need of the hour in Indian urban cities, with the explosion of Respiratory disease. Here at Aster CMI, we aim to provide a high level of expertise in Respiratory Critical Care. This is done adopting a unique approach combining state-of-the-art infrastructure, equipment, with skilled and experienced personnel including both physicians, nurses, and other para-medical staff. There is a severe dearth of centers providing such a comprehensive approach in our country.
- Other State-of-the-Art Life Saving Critical Care facilities
We have expertise in life-saving methodologies and technologies which can impact on outcomes in critically ill patients including:
- Prone Ventilation for ARDS and Respiratory failure
- VV ECMO
- Therapeutic Hypothermia post-cardiac arrest
- Non-Invasive Ventilation, to avoid invasive ventilatory support in patients with Respiratory Failure and Congestive Heart Failure
The Critical Care Services offered by the Department include:
Respiratory failure due any cause including but not limited to:
- Pneumonia – Community acquired/Hospital-associated/Viral/H1N1
- Acute severe COPD Exacerbations and Acute severe Asthma/Status asthmaticus
- ARDS (Acute Respiratory Distress syndrome)
- Pulmonary Embolism
- OSA and other Type II respiratory failures
Shock due to any cause, commonly:
- Sepsis and septic Shoc
- Management of Multiorgan dysfunction (MODS)
- Expertise in Cardiopulmonary Resuscitation, and post-Cardiac Arrest Care
- Post operative Critical Care.
- Neurological Critical Care
- Intractable seizures
- Coma And altered sensorium due to any cause
- Renal Failure
- Cardiac problems requiring critical care
- Toxicological problems
- Drug Overdose
- Complete and split overnight Polysomnography
- Multiple sleep latency test (MSLT)
- CPAP titration with sleep study
- Bronchoscopy Lab
- Fibroptic bronchoscopy with video scope and BAL
- Trans bronchial needle aspiration
- Trans bronchial biopsy
- Trans-bronchial lung biopsy
- Tracheal stenting
- Endo bronchial glue therapy
- Cauterization and removal of endobronchial growth
- Foreign body removal with Basket
- Medical thoracoscopy for diagnosis and treatment of Pleural diseases
- Pulmonary Function Lab
- Pulmonary function testing (PFT)
- PFT with Bronchodilator response
- PFT with diffusion study, Lung volumes, PI max and PE max