In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the respiratory tract andrespiratory disease. It is called chest medicine and respiratory medicine in some countries and areas. Pulmonologyis generally considered a branch of internal medicine, although it is closely related to intensive care medicine (aka critical care medicine) when dealing with patients requiring mechanical ventilation. Chest medicine is not a specialty in itself but is an inclusive term which pertains to the treatment of diseases of the chest and contains the fields of pulmonology, thoracic surgery, and intensive care medicine.
In the United Kingdom, Ireland, South Africa and Australia the term “respiratory physician” is used rather than pulmonologist to distinguish a physician that practices pulmonology. In Canada, respirology and respirologist are used. Surgery of the respiratory tract is generally performed by specialists in cardiothoracic surgery (or thoracic surgery), though minor procedures may be performed by pulmonologists. As mentioned above, pulmonology is closely related to critical care medicine when dealing with patients that require mechanical ventilation. As a result, many pulmonologists are certified to practice critical care medicine in addition to pulmonary medicine. There are fellowship programs that allow physicians to become board certified in pulmonary and critical care medicine simultaneously. Interventional pulmonology is a relatively new field within pulmonary medicine that deals with the use of procedures such as bronchoscopy to treat several pulmonary diseases. Interventional pulmonology is not its own specialty.
The pulmonologist begins the diagnostic process with a general review focusing on:
As many heart diseases can give pulmonary signs, a thorough cardiac investigation is usually included.
Other tools include:
Surgical treatment is generally performed by the (cardio)thoracic surgeon, generally after primary evaluation by a pulmonologist. Medication is the most important treatment of most diseases of pulmonology, either by inhalation (bronchodilators and steroids) or in oral form (antibiotics, leukotriene antagonists). A common example being the usage of inhalers in the treatment of inflammatory lung conditions such as Asthma or Chronic obstructive pulmonary disease. Oxygen therapy is often necessary in severe respiratory disease (emphysema and pulmonary fibrosis). When this is insufficient, the patient might require mechanical ventilation.
Pulmonary rehabilitation or respiratory therapy may be initiated as a treatment after all or most other treatments do little to help the patient. Pulmonary rehabilitation is for patients whose respiratory function has decreased or improved very little, even with extensive medical treatment. Pulmonary rehabilitation is intended to educate the patient, the family, and improve the overall quality of life and prognosis for the patient. Although a pulmonologist may refer a patient to therapy, the therapy is generally practiced by respiratory therapists.