What Are Respiratory & Critical Care Conditions?
The lungs are essential to life, and respiratory diseases represent a major global health burden. Respiratory medicine (pulmonology) encompasses the diagnosis and treatment of conditions affecting the airways, lung parenchyma, pulmonary vasculature, and pleura. Critical care medicine manages life-threatening conditions requiring intensive monitoring and organ support. Shanghai's Ruijin Hospital respiratory and critical care department, led by Professor Qu Jieming, is one of China's most prestigious, combining clinical excellence with cutting-edge research in pulmonary medicine and intensive care.
Common Respiratory Conditions
- Chronic obstructive pulmonary disease (COPD) — progressive airflow obstruction from emphysema and chronic bronchitis; the third leading cause of death globally
- Asthma — chronic inflammatory airway disease causing reversible bronchospasm; affects over 300 million people worldwide
- Interstitial lung disease (ILD) — a group of disorders causing progressive lung scarring (fibrosis); includes idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, and connective tissue disease-associated ILD
- Pulmonary embolism (PE) — blood clot in the pulmonary arteries; a medical emergency
- Pulmonary hypertension — elevated pressure in the pulmonary arteries causing right heart failure
- Severe pneumonia — including community-acquired, hospital-acquired, and ventilator-associated pneumonia
- Bronchiectasis — permanent dilation of the bronchi causing chronic infection and productive cough
- Pleural disease — pleural effusion, empyema, pneumothorax, and mesothelioma
- Obstructive sleep apnea (OSA) — repeated upper airway collapse during sleep causing oxygen desaturation
- Acute respiratory distress syndrome (ARDS) — life-threatening lung failure requiring ICU management
Symptoms
- Persistent or worsening shortness of breath (dyspnea)
- Chronic cough — with or without sputum production
- Wheezing or chest tightness
- Coughing up blood (hemoptysis)
- Chest pain — pleuritic (sharp, worse with breathing) or central
- Fatigue and reduced exercise tolerance
- Recurrent respiratory infections
- Cyanosis — bluish discoloration of lips or fingertips in severe disease
- Leg swelling (from pulmonary hypertension or cor pulmonale)
- Daytime sleepiness and morning headaches (sleep apnea)
Causes & Risk Factors
- Smoking — the primary cause of COPD and a major risk factor for lung cancer and ILD
- Air pollution — particularly relevant in urban China; contributes to COPD, asthma, and lung cancer
- Occupational exposures — asbestos, silica, coal dust, organic antigens (hypersensitivity pneumonitis)
- Autoimmune diseases — rheumatoid arthritis, scleroderma, myositis causing ILD
- Genetic factors — alpha-1 antitrypsin deficiency (COPD), TERT/TERC mutations (IPF)
- Obesity — major risk factor for sleep apnea and obesity hypoventilation syndrome
- Immobility and hypercoagulable states — risk factors for pulmonary embolism
- Prior lung infections — tuberculosis causing bronchiectasis and fibrosis
Diagnosis
Ruijin Hospital's respiratory team uses comprehensive pulmonary assessment:
- Pulmonary function tests (PFTs / spirometry) — essential for COPD and asthma diagnosis and severity staging
- High-resolution CT (HRCT) of the chest — gold standard for ILD characterization and lung parenchymal assessment
- CT pulmonary angiography (CTPA) — for pulmonary embolism diagnosis
- Bronchoscopy with BAL and biopsy — for infection, ILD, and endobronchial lesion assessment
- Cryobiopsy and surgical lung biopsy — for definitive ILD histological diagnosis
- Echocardiography — for pulmonary hypertension assessment and right heart function
- Right heart catheterization — gold standard for pulmonary hypertension diagnosis and classification
- Polysomnography (sleep study) — for sleep apnea diagnosis and severity assessment
- Arterial blood gas (ABG) — for respiratory failure assessment
- Exhaled nitric oxide (FeNO) — for eosinophilic airway inflammation in asthma
Treatment Options
Ruijin Hospital offers the full spectrum of respiratory and critical care treatments:
- Inhaled bronchodilators and corticosteroids — LABA, LAMA, ICS combinations for COPD and asthma; optimized via spirometry-guided step-up therapy
- Biologic therapy for severe asthma — Dupilumab, Mepolizumab, Benralizumab, Omalizumab targeting specific inflammatory pathways
- Antifibrotic therapy for IPF — Nintedanib and Pirfenidone to slow lung fibrosis progression
- Pulmonary rehabilitation — structured exercise and education program for COPD and ILD patients
- Bronchial thermoplasty — bronchoscopic procedure for severe refractory asthma; reduces smooth muscle mass
- Pulmonary hypertension therapy — Endothelin receptor antagonists (Bosentan, Ambrisentan), PDE5 inhibitors (Sildenafil), prostacyclin analogues (Epoprostenol, Treprostinil), Riociguat
- Anticoagulation for pulmonary embolism — DOACs (Rivaroxaban, Apixaban), LMWH, catheter-directed thrombolysis for massive PE
- Non-invasive ventilation (NIV/BiPAP) — for COPD exacerbation, hypercapnic respiratory failure, and sleep apnea
- CPAP therapy — for obstructive sleep apnea
- Mechanical ventilation and ICU management — lung-protective ventilation strategies for ARDS; prone positioning, neuromuscular blockade
- ECMO (extracorporeal membrane oxygenation) — for refractory respiratory or cardiac failure; Ruijin Hospital has an experienced ECMO program
- Pleural procedures — thoracentesis, chest tube drainage, pleurodesis, medical thoracoscopy
- Lung transplantation evaluation — pre-transplant workup and referral coordination for end-stage lung disease
Why Treat Respiratory Disease in Shanghai?
- Ruijin Hospital's respiratory and critical care department is one of China's most prestigious, with Professor Qu Jieming as a nationally recognized leader in pulmonary medicine
- Comprehensive ILD program with multidisciplinary team including pulmonologists, rheumatologists, and radiologists
- Advanced ECMO program for the most critically ill patients
- Access to the latest biologic therapies for severe asthma and antifibrotic agents for IPF
- Treatment costs significantly lower than equivalent care in Western countries
Our Specialist
Professor Qu Jieming (矍介明) — Chief of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Professor Qu is one of China's foremost pulmonologists, with particular expertise in severe pneumonia, ARDS, mechanical ventilation, and respiratory infections. He played a leading role in China's clinical response to major respiratory disease outbreaks and has published extensively in top international journals.
How CMCS Can Help
China Medical Concierge Shanghai (CMCS) coordinates comprehensive respiratory care for international patients at Ruijin Hospital — from reviewing your pulmonary function tests and CT imaging, to arranging specialist consultations, facilitating bronchoscopy and lung biopsy procedures, coordinating ICU admission for critical cases, providing medical interpretation, and supporting long-term disease management and follow-up care.
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