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Axel Hall
Axel Hall

Pediatric Respiratory Diseases: A Comprehensive...

Our pediatric pulmonary team is a multidisciplinary team comprised of three board-certified pediatric pulmonologists, a full-time clinical nurse, a nutritionist, a social worker and clinical respiratory therapists. We provide diagnosis and treatment for a wide variety of respiratory illnesses in infants, children and adolescents. We offer comprehensive outpatient and inpatient consultation and follow-up of a variety of complex respiratory conditions including asthma, chronic lung disease of prematurity, cystic fibrosis, chronic respiratory failure, rare lung diseases, neuro-muscular and chest wall disorders, bronchiectasis, congenital lung anomalies, airway anomalies, technologically dependent children (children on non-invasive and invasive ventilation), as well as a range of sleep disorders.

Pediatric Respiratory Diseases: A Comprehensive...

The Division of Pediatric Pulmonary and Sleep Medicine provides comprehensive care to infants, children and adults with a full spectrum of respiratory disorders. The division is committed to excellence and is nationally recognized for quality of patient care, education, research and advocacy. Care is guided in all age groups by the routine measurements of lung function, including pre-school age testing that is unique and unavailable at other pediatric centers. Disease-specific programs driven by pulmonary faculty include the Duke Children's Cystic Fibrosis Center, Duke Asthma, Allergy and Airway Center, Duke Pediatric Sleep Disorders Program, and the Duke Neuromuscular Program. Comprehensive multi-disciplinary care is provided by physicians, nurse practitioners, nutritionists, physical therapists and social workers. The transitional program to adult care in cystic fibrosis was one of the first in the nation.

SF-36 score is the most common indicator for assessing the life quality. Usually, the quality of life is significantly decreased in pediatric patients with respiratory failure since their lives are severely affected [21]. Moreover, the reduced life quality can further undermine the self-esteem and self-confidence of pediatric patients. Maximizing the recovery of life quality has become one of the important rehabilitation goals. The results of this study showed that SF-36 score in the observation group was much higher than that in control group, indicating that comprehensive nursing care can significantly improve the life quality in pediatric patients with respiratory failure. This is consistent with the results reported by Fan et al. [22].

The Division of Pediatric Pulmonology, Allergy and Sleep Medicine in the Department of Pediatrics at IU School of Medicine is a national leader in clinical care, teaching and research in pediatric respiratory medicine. As the only comprehensive pediatric respiratory medicine program in Indiana, this team of faculty pediatricians cares for children throughout the state and regionally.

Use of the pulmonary physiology and sleep laboratories are important adjuncts of diagnosis and management. Fellows are also expected to master procedures required for subspecialists, notably flexible fiberoptic bronchoscopy. In general, fellows are required to gain experience in asthma, bronchopulmonary dysplasia, cystic fibrosis, pulmonary infections, respiratory disorders in systemic diseases and in immunocompromised hosts, neuromuscular diseases, disorders of ventilatory control, interstitial lung diseases, congenital malformations of the respiratory system, etc.; and the use of supplemental oxygen, home mechanical ventilation, non-invasive mask ventilation, and other technologies. Fellows generally function at a junior consultant level, providing consultation, guidance, and education to Pediatric house officers. Fellows are also required to have a continuity clinic over their entire 3-years, where they follow a select number of patients with a variety of disorders to learn the long-term management of pediatric respiratory disorders.

As a parent, watching a child suffer from a respiratory disorder can be frightening and worrisome. Our respiratory specialists provide compassionate care for a wide-range of pediatric respiratory disorders. We also oversee one of the largest cystic fibrosis programs in the country.

This Cystic Fibrosis Center clinic staff includes pediatric pulmonology, pediatric gastroenterology, clinical nurse coordination, registered dietitian, respiratory therapist, medical social work, and access to clinical research protocols.

Dr. Kazachkov is a specialist in pediatric bronchoscopy and airway diseases. His research interests include chronic cough and the relationship between gastroesophageal reflux and aspiration to respiratory disease.

This is a comprehensive and authoritative textbook on pediatric pulmonology. Edited by Pablo Bertrand and Ignacio Sánchez, renowned academics and pediatricians from the Pontifical Catholic University of Chile, it encompasses five sections and 74 chapters, presenting and discussing the most important topics related to pediatric respiratory diseases. Written and presented in a simple and didactic format, it intends to ease learning and settlement of doubts in pediatric respiratory diseases. The reader is naturally introduced into the physiology, diagnosis, syndromes, diseases and the treatment associated with the respiratory pathologies affecting children. The chapters include algorithms for the treatment of various syndromes and updated treatment proposals grounded in evidence-based medicine for more than 50 pulmonary diseases.

At our pediatric specialty care hospital, respiratory therapists treat patients ranging from infants with respiratory insufficiency requiring ventilator support to pediatric asthmatics and patients with chronic pulmonary diseases. Our respiratory therapists also work closely with physicians, nurses and other health care staff to help develop, modify and implement individual patient care plans that provide for a more seamless and comprehensive patient experience.

At Baylor Scott & White McLane Children's, our pediatric pulmonologists work as part of a multidisciplinary team of experienced professionals that includes pediatric pulmonologists, a nurse practitioner, a nurse educator, a respiratory therapist, a nutritionist, a social worker, a Child Life specialist and a pharmacist who are devoted to the care of infants, children, and adolescents afflicted with breathing disorders.

A Pediatric Pulmonologist provides comprehensive evaluation and management for children with respiratory disorders, including chronic/recurrent cough or wheezing, asthma, pneumonia, pleural effusions, apnea, sleep-disordered breathing, hypoventilation syndromes, chronic lung disease, chronic respiratory failure, congenital lung malformations, lung transplantation and interstitial lung disease. Many pulmonologists specialize in the care of patients with cystic fibrosis. Pediatric lung disease specialists may also specialize in sleep medicine. By virtue of training, experience, and curiosity, the pediatric pulmonologist is intimately involved in research, teaching, and public policy/advocacy. Pediatric pulmonology procedures include flexible fiberoptic bronchoscopy, bronchoalveolar lavage, transbronchial and mucosal biopsies, and interpretation of pulmonary function studies and polysomnograms.

For those who work within an academic setting, duties are divided between patient care, teaching, research, and administration. The specific allocation of time depends on the interests of the Pediatric Pulmonologist and the needs of the institution. Some pulmonologists maintain a general clinical practice, while others develop a niche in caring for a subset of patients (e.g. patients with cystic fibrosis, chronic respiratory failure, asthma, interstitial lung disease, or sleep-disordered breathing). Because of the chronic nature of many pulmonary disorders, the Pulmonologist has an opportunity to develop longstanding relationships with patients and their families. In general, most pediatric pulmonologists participate in both inpatient and outpatient care of patients as well as perform flexible bronchoscopies during their clinical time. Pediatric pulmonology clinical service does not typically require in hospital overnight call. Night and weekend call are taken at home. Most academic pediatric pulmonary divisions are group practices. There are a small number of private practice opportunities for pediatric pulmonologists. Some of these practices may have hospital affiliations as part of their practice.

Practitioners often cite the mix of acute and chronic disease, ability to form relationships with patients and families, and the integration of physiology with basic science principles in the approach to disease management as reasons for choosing pediatric pulmonology as a specialty. Others have been drawn by an interest in a particular disease (i.e. cystic fibrosis, asthma) or intervention (mechanical ventilation, bronchoscopy). The Pediatric Pulmonologist is in demand from every specialty, because so many illnesses ultimately result in respiratory involvement. Many have chosen pediatric pulmonology because of a desire to improve the lives of children with specific illnesses such as cystic fibrosis, asthma, bronchopulmonary dysplasia, or chronic respiratory failure due to neuromuscular diseases, to name a few.

This center aligns pediatric specialists from allergy and immunology, pulmonology, respiratory therapy, and more to provide expert diagnosis, personalized care plans, and comprehensive education for patients with asthma. Fellows see asthma patients within the center and have the opportunity to engage in basic science, translational, and clinical asthma research. 041b061a72


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