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Obstructive Sleep Apnoea (OSA)
The Obstructive Sleep Apnoea (OSA) service deals with the investigation and
management of patients with OSA. There are two dedicated cross-city Sleep
Physiology services, as part of the Pulmonary Function Units, at the Northern
General Hospital (Leslie Mattock, Ext. 14044) and the Royal Hallamshire Hospital
(Alison Proctor/ Cath Billings, Ext. 11807), and a Consultant Respiratory
Physician (Dr Eddie Moloney Ext. 14646) with a special interest in OSA and
Non-Invasive Ventilation.
Diagnostic evaluation includes sleep questionnaires, an evaluation of somnolence
(Epworth Sleep Score (ESS) and OSLER testing), body mass index and blood
pressure recording, pulmonary function testing, overnight oximetry recording,
and limited polysomnography (LPSG) recording. Treatment evaluation includes both
variable pressure and fixed pressure continuous positive airway pressure (CPAP)
trials, with overnight oximetry or LPSG recording, and sleep hygiene monitoring
and advice. For those issued with a CPAP machine, a full back up of monitoring/
troubleshooting and servicing of CPAP equipment is available through the
Pulmonary Function Units at both the NGH and RHH. There are also close liaisons
between the OSA service, and ENT, Neurology, Endocrinology, Maxillo-facial, and
the Obesity service.
Acute Non-Invasive Ventilation (NIV)
The acute NIV service is based on the 4-bedded Respiratory Support Unit (RSU),
Brearley 1 ward (Ext 15089/ 15090), at the Northern General Hospital. This
service provides NIV for patients with persistent hypercapnic ventilatory
failure, during acute exacerbations of COPD, despite optimal medical treatment.
The unit is a designated level 2 HDU area of care, and has a Charge Nurse
(Richard Kemp), Lead Physiotherapist (Matt Cox), and Lead Consultant Respiratory
Physician (Dr Eddie Moloney). The NIV service for acute COPD is available on a
24/7 basis and has full Nursing and Consultant Respiratory cover. All beds are
monitored beds, which are centrally linked to the Nursing station, and the
adequacy of the ventilatory response to NIV is measured transcutaneously.
Referrals to the RSU can be made by ringing the ward (Ext 15089/ 15090) or bleep
629.
Domicillary Non-Invasive Ventilation
The domiciliary NIV service deals with the management and follow-up of patients
in chronic ventilatory failure from a variety of causes e.g. Motor Neuron
Disease, Duchennes Muscular Dystrophy, Kyphoscoliosis, COPD, Obesity
Hypoventilation, amongst others. There are two dedicated cross-city Physiology
services, the Royal Hallamshire Hospital (Alison Proctor/ Cath Billings, Ext.
11807), and the Northern General Hospital (Leslie Mattock, Ext. 14044), who
specialise in the management of domiciliary NIV, and a Consultant Respiratory
Physician (Dr Eddie Moloney Ext. 14646) with a special interest in Non-Invasive
Ventilation. Diagnostic evaluation includes full pulmonary function testing,
respiratory muscle strength testing, overnight oximetry recording, limited
polysomnography (LPSG) recording, and arterial blood gas and transcutaneous CO2
monitoring. For those issued with an NIV machine, a full back up of monitoring/
troubleshooting and servicing of NIV equipment is available through the
Pulmonary Function Units at both the RHH and NGH.
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