Pulmonary and Critical Care Medicine

Respiratory Acute Care Unit

The Respiratory Acute Care Unit cares for patients who need help breathing, either with or without the assistance of a respirator (i.e. mechanical ventilator).

Focused Respiratory Care

Most of the patients at the Massachusetts General Hospital Respiratory Acute Care Unit (RACU) come from various intensive care units in the hospital. Our patients have survived a period of critical illness, but must have their breathing assisted with a respirator or have impaired lung function that requires intensive monitoring and treatment.

If you need the assistance of a respirator, we focus on weaning you off as quickly as possible. As a result, you will:

  • Be less likely to contract a serious infection
  • Spend less time in the hospital
  • Be able to start physical therapy and rehabilitation sooner, which can contribute substantially to improvement in mood and attitude

 Our physicians and respiratory therapists excel in helping patients speak while using a respirator following a tracheostomy (the surgical creation of an opening into the trachea for insertion of a breathing tube).

If you do not or no longer require a respirator, we will continue to manage your needs related to your lung function and critical illness until you are ready to be transferred to a general ward or rehabilitation hospital.

A Multidisciplinary Care Team

The RACU has 10 beds and admits about 250 patients a year. Members of our multidisciplinary team work together to apply their expertise in treating the variety of conditions seen in our unit. The team includes:

  • Physicians who specialize in pulmonology and critical care medicine
  • Physicians who specialize in anesthesiology and critical care medicine
  • Pulmonary fellows
  • Nurses
  • Case managers
  • Respiratory, physical and occupational therapists
  • Speech language pathologists
  • Pharmacists
  • Nutritionists
  • Social workers
  • Unit maintenance staff

The RACU is administered jointly by the Division of Pulmonary and Critical Care Medicine of the Department of Medicine and the Critical Care Division of the Department of Anesthesia, Critical Care and Pain Medicine. The directors are Robert Brown, MD, and Ulrich Schmidt, MD, PhD.

What to Expect

The core of your care team consists of an attending physician, pulmonary fellow, nurse practitioner and respiratory therapist. The team meets daily to examine you, review your progress and discuss your plan for the day and long-term goals.

Upon your request, your care team can arrange a meeting with you and your family. In addition, the nurse practitioner serves as a "point person" to communicate with you on a regular basis.

Depending on your particular situation, your stay in the RACU may last anywhere from days to months.

Research Aimed at Improving Patient Care

Research studies may be ongoing at any time in the RACU. The purpose is to evaluate potential new methods for improving patient care. Patients may choose whether or not to participate without compromising the care that they receive.

An Emphasis on Staff Education

Assignments in the RACU are an important part of the training of critical care fellows and nurses. Nurses receive extensive education during an eight- to 12-week RACU orientation program. For continuing education of the existing staff, team members attend conferences, conduct research, and consult and collaborate with Mass General consultants.