Clinical Programs and Services
The Pediatric High Risk Asthma Program is a joint program of the Divisions of Pediatric Pulmonary Medicine and Allergy-Immunology. Each Wednesday afternoon clinic is staffed by asthma –specialist faculty and pulmonary and allergy-immunology fellows. Patients with high risk asthma are seen in a multidisciplinary clinic which includes nurse practitioners, nurses, respiratory care and social work. Specialized services such as allergy skin testing, immunotherapy, pulmonary function testing (including methacholine and exercise challenge testing) and referral to other specialists (ENT, GI) are readily available through this clinic.
Asthma QI and Clinical Research
Asthma is one of the most frequent causes of ED and hospital visits at Le Bonheur Children’s Hospital and the Pediatric Pulmonary Medicine division is actively involved in hospital efforts to improve asthma care in the hospital, ED, and outpatient clinic. Division faculty and staff participate on multidisciplinary asthma improvement efforts, and work in the community and schools to improve asthma outcomes through education of patients and families, primary caregivers, and other staff. Faculty and fellows also have the opportunity to participate in clinical and epidemiologic research in asthma.
Chronic Lung Disease of Infancy (Bronchopulmonary Dysplasia, BPD) Clinic
Memphis has one of the highest rates of prematurity in the nation and a significant number of infants with chronic lung disease are discharged from area nurseries. Many of these infants have significant oxygen requirements, and need careful follow-up as oxygen and chronic medications are weaned. The twice monthly CLD (B PD) Clinic provides a mechanism for the follow-up of premature infants with significant lung disease, apnea, or other complications during the crucial early months after nursery discharge. Infants are typically followed until weaned from oxygen. Improvement depends upon optimal growth and the role of the nutritionist in monitoring these infants is crucial. In addition the multidisciplinary clinic includes respiratory care and nursing.
Cystic Fibrosis (CF) Care and Research Center
The UT CF Care and Research Center at Le Bonheur Children’s Hospital/Methodist University Hospital strives to provide outstanding care to adult and pediatric patients with CF from West Tennessee, eastern Arkansas, and northern Mississippi. Our major strength is our very experienced CF care team that has worked together for many years, along with the outstanding support of the administration of Le Bonheur Children’s Hospital and of the Department of Pediatrics of the University of Tennessee. Our center is a CF Foundation Therapeutic Development Network (TDN) Center and we are actively involved in bringing new CF therapies to CF patients for clinical trials, with a dedicated CF research nurse coordinator. Our multidisciplinary CF team includes nursing, nutrition, respiratory therapy (RT), physical therapy (PT), social work, pharmacist, child life, and palliative care, all working together in a collaborative way.
In addition the center team works closely with the CF Patient and Parent Advisory Council (PPAC). The PPAC and CF Center plan a yearly to twice yearly Family Education Day and a yearly CF team retreat focused on improving care. The Adult CF Care Program is centered at Methodist University Hospital (LINK) and includes monthly clinics and a dedicated adult CF care team including pulmonologists, RT, nursing, nutritionist, and social work.
Pulmonary Function and Infant PFT Laboratories
The Division oversees two fully equipped, modern pediatric pulmonary function laboratories staffed by specially trained technicians and respiratory therapists at LeBonheur Children’s Medical Center and St. Jude Children’s Research Hospital. These laboratories provide state-of-the art testing for children from the Mid-South on both an inpatient and outpatient basis. Tests provided include spirometry (approximately 250 studies per month ), specialized bronchoprovocation testing, measurement of lung volumes by plethysmography, and measurement of carbon monoxide diffusing capacity. In addition, indirect calorimetry can be performed on selected children using our metabolic cart equipment. Our infant pulmonary function laboratory, one of only 39 such laboratories in the United States and the only one in the state of Tennessee, provides spirometry and plethysmographic lung volume measurements in infants with lung disorders. All pulmonary function tests are interpreted by pediatric pulmonology division faculty.
The Division performs all flexible fiberoptic bronchoscopies at LeBonheur Children’s Medical Center and at St. Jude Children’s Research Hospital (average 200 procedures per year) for airway evaluation of children. During these procedures, bronchoalveolar lavage and in selected patients, transbronchial amd and mucosal biopsies are performed for diagnosis as well as to relieve atelectasis. In collaboration with the pediatric critical care and anesthesia staff, we also perform intubation of the difficult airway. All bronchoscopies are performed in the operating room or in the pediatric critical care units at the respective hospitals under conscious or general anesthesia to maximize safety for the patients. Patients who may need rigid bronchoscopy or other surgical and endoscopic procedures for complex airway and aerodigestive disorders are done in consultation and collaboration with colleagues in pediatric surgery, pediatric otolaryngology, and pediatric gastroenterology.