Updates from the Division of Pulmonary and Sleep Medicine

Julian Allen, MD An update from Julian Allen, MD, Chief of the Division of Pulmonary and Sleep Medicine

2018—19 has been an exciting year for the Division of Pulmonary and Sleep Medicine at Children’s Hospital of Philadelphia (CHOP). Here are highlights of new developments in our clinical and research programs and with our staff.

Clinical Programs

The division has 9 distinct specialty programs in addition to caring for children across the entire spectrum of pediatric pulmonary disorders. Follow the links for more information.

• Asthma Program: For children with difficult to control asthma, we offer the Severe Asthma Multidisciplinary Clinic and, in concert with our Allergy colleagues, the Pulmonology and Allergy Personalized Asthma Clinic. Qualified families of children with persistent asthma whose homes require renovations to reduce triggers can access a first-in-the-nation program, CAPP. Learn more. Led by Jeff Ewing, MD.
• Sleep Center: Under the leadership of Clinical Director Suzanne Beck, MD, and Research Director Ignacio Tapia, MD, who were appointed following the 2017 untimely death of internationally recognized, long-time director Carole Marcus, MBBS, the center sees more than 2000 patients in clinic and performs more than 2400 sleep studies a year in 3 locations. Led by Sue Beck, MD, and Ignacio Tapia, MD.
• Cystic Fibrosis Center: Our multidisciplinary center has an active quality improvement program, and a transition program with the Adult CF Center at the Hospital of the University of Pennsylvania. Clinical research includes participation in the CF Foundation Therapeutic Development Network’s multicenter trials of new corrector agents for the basic protein defect in CF and a cutting-edge research and treatment program for CF-related diabetes. Led by Ron Rubenstein, MD, PhD.
• Technology Dependence Program: Follows more than 800 patients with various underlying disorders leading to chronic respiratory failure requiring invasive or non-invasive ventilation. These include chronic lung disease of infancy and childhood, neuromuscular disorders, chest wall disorders, and pulmonary complications of complex congenital heart disease. The physiology of these disorders is studied and, when appropriate, weaning and liberation from mechanical ventilation are achieved. Led by Howard Panitch, MD.
• Lung Transplant Program: Has performed more than 100 lung transplants, including transplanting infants. The center is a national referral center for children with end-stage cardiopulmonary disease and participates in multicenter research studies and he development of standardized protocols. Led by Sam Goldfarb, MD.
• Children’s Interstitial Diffuse Lung Disease Center: a national referral center for interstitial lung disease and part of the Childhood Interstitial Lung Disease (chiLD) National Network, performing research to better discern the genetic links between disorders such as bronchiolitis obliterans and idiopathic pulmonary hemosiderosis. Led by Sam Goldfarb, MD.
• Primary Ciliary Dyskinesia Center: Our large patient base gives us the expertise to quickly and accurately diagnose this rare condition and setting the optimal treatment course. We are an active participant in a national PCD Center Care Network and in clinical trials in this disorder. Led by Maureen Josephson, DO.
• Center for Thoracic Insufficiency Syndrome and Neuromuscular Disease Program: This center partners with Orthopedics and Neurology to develop management protocols for these patients and perform physiologic research and clinical trials. Led by Oscar (Hank) Mayer, MD.
• Center for Pediatric Airway Disorders: Pulmonology is a partner with Otolaryngology and Gastroenterology in this center that offers families collaborative diagnosis, including triple endoscopies (flexible bronchoscopy, rigid bronchoscopy, and esophagogastroduodenoscopy) and treatment, teaming with gastroenterologists, otolaryngologists, and speech pathologists). One marker of its success is 90 patients in the program have had their tracheotomy decannulated in the past 2.5 years. In 2018, the program added a second full-time pulmonologist and will be adding a fifth otolaryngologist in 2019. In the research realm, Ricardo Gottardi, a bioengineering assistant professor, was recently recruited to develop novel treatments for airway disorders. Led by Joe Piccione, DO.

Education

We are pleased to announce the continued growth of CHOP’s Pulmonary and Sleep Medicine Fellowship Program. Starting in summer 2019, we will have 3 training slots per year for the 3-year fellowship, with plans to have a full cadre of 9 fellows in 2021. In addition, through a joint fellowship with the University of Pennsylvania and CHOP, there is a sleep medicine fellowship offering slots to 1 to 2 pediatric sleep fellows with opportunity for competitive research funding via a T-32 training grant.

Research

The Division performs a wide spectrum of research, either based within the specific clinical programs listed above, or trans-programmatic and collaborative with other entities at Penn and at CHOP. Our research spans the spectrum across basic science, physiology, clinical trials, and research spanning bench to bedside. View some examples of research performed in the Pulmonary Division, and read about some interesting analogies between the physiology of the respiratory system and stringed musical instruments. A reference list for some of the studies cited above is available on request.

Division to Welcome New Division Chief

Lisa Young, MD On June 1, 2019, after over 20 years as Chief of the Division of Pulmonary and Sleep Medicine, I will be handing over leadership to Lisa Young, MD, who comes to CHOP from the Monroe Carell Jr. Children’s Hospital at Vanderbilt, where she is currently Director of the Center for Childhood Lung Research and the Pediatric Rare Lung Diseases Program. Dr Young earned her MD at Duke University, completed residency training in Pediatrics and Internal Medicine at Duke University, and completed fellowship training in Pediatric Pulmonology and Adult Pulmonary/Critical Care Medicine at Cincinnati Children’s Hospital Medical Center and the University of Cincinnati. She is an international expert in rare and genetic lung diseases in children, including interstitial lung disease, and is currently principal investigator on multiple National Institutes of Health grants.

The Division at large, and the ILD program in particular, are incredibly excited about her plans for expanding our many excellent clinical programs, some of which were highlighted above, as well as promoting interdisciplinary research at CHOP and the University of Pennsylvania and enhancing our fellowship training program. I will continue my practice of general pediatric pulmonology, as well take a year sabbatical to study the forced oscillation technique as a test of preschool lung function and its potential incorporation into clinical practice.

Other Transitions

Two notable pediatric pulmonary physicians, Raezelle Zinman, MD, and Lee Brooks, MD, retired this past year. Their many contributions to the care of children with respiratory and sleep disorders, as well as to the base of knowledge in respiratory system mechanics and pediatric sleep medicine, will be missed and long remembered and studied.