Pediatric Pulmonology and Sleep Medicine Clinical Affairs
The Division of Pediatric Pulmonology and Sleep Medicine provides care to infants and children with a wide spectrum of respiratory illnesses, including disorders of respiratory control, the chest wall, respiratory muscles, airway and lung parenchyma, and cystic fibrosis at Children’s Medical Center’s two campuses.
Inpatient Services
The inpatient population consists primarily of patients with cystic fibrosis, chronic respiratory failure on mechanical ventilation, and neuromuscular diseases hospitalized for an acute respiratory process. If we have bed availability, we also manage patients with high-risk asthma and less common pulmonary issues, such as primary ciliary dyskinesia, hereditary hemorrhagic telangiectasia, and idiopathic pulmonary hemosiderosis, as well as other interstitial lung diseases. We do frequently admit patients with tenuous airways or who need noninvasive mechanical ventilation when ICU acuity is no longer needed.
In addition to a dedicated inpatient service, our two consultation services provide care for children across the Dallas campus, offering expert pulmonary management for patients with a wide variety of diagnoses. The consultation services collaborate closely with teams in the Pediatric Intensive Care Unit, Cardiovascular Intensive Care Unit, Neonatal Intensive Care Unit, and other general and specialty services.
Our procedural service includes diagnostic and therapeutic bronchoscopy, including interventional procedures such as cryotherapy and foreign body evaluation. An attending pulmonologist is assigned at all times to both the inpatient pulmonology service and to both consultation services to ensure continuous coverage and high-quality patient care.
Outpatient Services
Outpatient activities include not only a large general pulmonology practice but also innovative and comprehensive multidisciplinary care for complex patients. In addition to our nationally recognized Cystic Fibrosis Care Center, we offer high-quality care to the most complex patients through the Sleep Program, High-Risk Asthma Clinic, Primary Ciliary Dyskinesia Center, and Ventilator Clinic.
- Claude Prestidge Cystic Fibrosis Care Center
The Pediatric Cystic Fibrosis Program, co-directed by Preeti Sharma, M.D. (Pediatric Pulmonology and Sleep Medicine), and Meghana Sathe, M.D. (Pediatric Gastroenterology), is one of the largest in the country, with over 280 pediatric patients. The center provides a comprehensive, multidisciplinary team approach to this complex and chronic disease.
They are actively involved in numerous multicenter trials through the CFF Therapeutics Development Network, including clinical trials of new and innovative treatments. The Cystic Fibrosis Care Center continues to grow and provide outstanding clinical care and cutting-edge research to the children of North Texas and beyond.
As founding members of the CF Learning Network, their work in quality improvement and process improvement has led to national recognition in these areas. They are also active participants in the CFF Success with Therapies Research Consortium, which allows for collaboration in qualitative research. Through this consortium, they work to better understand and improve mental health and adherence to therapies in the cystic fibrosis community. The team is committed to improving care for their patients and serves as a model for care centers across the country.
- Pediatric Sleep Program
Under the direction of Syed Kamal Naqvi, M.D., our Sleep Center provides comprehensive care for all pediatric sleep disorders, including obstructive and central sleep apnea, narcolepsy, hypersomnia, insomnia, circadian rhythm disorders, and behavioral sleep disorders. A licensed sleep psychologist offers cognitive behavioral therapy for insomnia. Two PAP specialists provide mask fitting sessions and expertise for other equipment-related issues.
Our 24-bed sleep lab (divided between our Dallas and Plano locations) performs over 4,000 outpatient sleep studies per year and inpatient sleep studies as needed, including diagnostic sleep studies, PAP titration studies, multiple sleep latency tests, and maintenance of wakefulness tests. The Sleep Program also participates in numerous multicenter research trials. The Sleep Center and faculty are part of clinical training and faculty for a sleep medicine fellowship at UTSW, with three fellows trained each year.
- High-Risk Asthma Clinic
The High-Risk Asthma Clinic aims to provide multidisciplinary care for difficult-to-control and severe asthmatics. Initially established by the joint efforts of Tanya Martinez-Fernandez, M.D., and Yadira Rivera-Sanchez, M.D., the clinic is currently led by Dr. Martinez-Fernandez and has incorporated Jeffrey Chambliss, M.D. (Division of Pediatric Allergy and Immunology), and Folashade Afolabi, M.D.
Dedicated time from specialists in physical therapy, psychology, nutrition, social work, case management, asthma education, and nursing has allowed us to improve care with the aim of reducing emergency department visits and hospitalizations and improving the quality of life for patients with life-threatening asthma. The High-Risk Asthma Program is also actively engaged in quality improvement efforts as well as clinical trials in asthma therapies.
- Primary Ciliary Dyskinesia Center
Since 2021, the PCD Foundation-accredited center, under the leadership of Dr. Rivera-Sanchez, has remained the only PCD center in North Texas. Our multidisciplinary clinic is supported by a nurse coordinator, social worker, dietitian, and psychologist, and it collaborates with the Department of Otolaryngology – Head and Neck Surgery, Division of Cardiology, and Division of Clinical Genetics. The comprehensive and expert care provided in the PCD Center has led to an increase in patients and expansion of the clinical program. In 2023, we were accepted into the multicenter PCD Foundation Registry project, which has led to growth in research opportunities and clinical trials.
In close collaboration with the adult pulmonology group at UTSW, we have guided their creation of an adult PCD program as well. This attention to patient care across the lifespan has allowed us to become one of the few pediatric programs in the U.S. with an associated adult program and the only one in Texas, furthering our national and international recognition.
- Multidisciplinary Ventilator Clinic
Andrew Gelfand, M.D., directs the Ventilator Clinic. This multidisciplinary clinic involves ENT, physiatry, respiratory therapy, nursing, social work, radiology, nutrition, physical therapy, and case management to provide comprehensive care to technology-dependent patients. The program follows more than 200 patients with chronic mechanical ventilator needs from a variety of causes, including bronchopulmonary dysplasia, neuromuscular weakness, congenital heart disease, high spinal cord injury, neurological impairment that leads to poor control of breathing, and other causes of respiratory insufficiency.
Dr. Afolabi is a member of the chronic ventilation team and has initiated work on creating a registry for the program to guide quality and process improvement work.
- Respiratory Manifestations of Neuromuscular Disease
Princy Ghera, M.D., and Aimee Robinson, M.D., collaborate with the Department of Neurology to provide specialized expertise on neuromuscular and chest wall-related respiratory diseases. Additionally, Dr. Robinson has spearheaded a program to focus on young children with Duchenne muscular dystrophy to ensure they have the specialized respiratory care they need early on. Dr. Ghera, trained in both medicine and pediatrics, has an interest in continuity of care for children as they grow to adulthood. With her expertise, there is a growing transition program for patients with respiratory disease related to neuromuscular issues.
Peter Luckett, M.D., who is trained in pediatric critical care and pulmonary medicine, continues to provide his expertise in management of adolescent patients with neuromuscular disease.
- Aerodigestive Clinic
Dr. Ghera directs the Pulmonary Aspects Multidisciplinary Aerodigestive Program. This program, under the leadership of Stephen Chorney, M.D. (ENT), combines the services of gastroenterology, pulmonology, and ENT specialists to provide expert and thorough care for children with complex medical needs. Pediatric patients are referred from all over the nation for a comprehensive evaluation of swallowing, breathing, and feeding disorders.
- Hereditary Hemorrhagic Telangiectasia (HHT)
Dr. Sharma directs the Hereditary Hemorrhagic Telangiectasia (HHT) Clinic. She has partnered with the adult HHT Center and the Divisions of Neuroradiology/Vascular Interventional Radiology, Pediatric Hematology and Oncology, and Pediatric Gastroenterology to provide comprehensive care for patients with this vascular disorder.
- Pulmonary-Sickle Cell Multidisciplinary Clinic
Devika Rao, M.D., along with An Pham, M.D. (Division of Pediatric Hematology and Oncology), directs a Pulmonary-Sickle Cell Interdisciplinary Clinic to address the pulmonary needs of children with sickle cell anemia. This clinic is housed in the Pauline Allen Gill Center for Cancer and Blood Disorders and allows for specialized multidisciplinary care. Dr. Robinson also helps with our sickle cell efforts.
- Pulmonary Function Lab
We have a robust and leading-edge lab with the ability to do spirometry, body plethysmography, FeNO, methacholine, and exercise challenges, as well as lung clearance index testing. The Pulmonary Function Lab performed more than 6,000 pulmonary function tests in 2024 and is one of the only ATS-accredited pulmonary function laboratories in the country.