The Pediatric Pulmonology and Sleep Medicine Division offers both inpatient and outpatient consultation for a wide variety of respiratory and sleep disorders in children.
The inpatient population consists primarily of patients with cystic fibrosis, chronic respiratory failure on mechanical ventilation and patients with neuromuscular diseases hospitalized for an acute respiratory process. If we have bed availability, we also like to manage patients with high-risk asthma as well as 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 non-invasive mechanical ventilation when ICU acuity is no longer needed. We also provide a consultation service to help with the needs of the rest of the hospital. This service typically has 20-30 patients, and we help advise respiratory management to patients throughout the hospital, including the Pediatric Intensive Care Unit, the Cardiovascular Intensive Care Unit, and the Neonatal Intensive Care Unit, as well as to the general and other specialty services. We also provide bronchoscopy services when indicated. Dr. Yadira Rivera-Sanchez oversees the inpatient activities of the Division. There is an attending pulmonologist assigned to the Pediatric Pulmonology and Sleep Medicine Service as well as the consultation service at all times.
Outpatient activities are comprehensive and primarily centered on a busy general pulmonology practice. Physicians combine their efforts with a group of talented and dedicated nurse practitioners, who conduct clinical consultations on selected patients. Additionally, the pulmonary division directs a few programs that also deserve mentioning.
- Tanya Martinez Fernandez, M.D., has led the development and organization of the outpatient clinics.
- The Pediatric Cystic Fibrosis program, one of the largest in the country with over 300 pediatric patients, is co-directed by Dr. Preeti Sharma from Pediatric Pulmonology and Sleep Medicine and Dr. Meghana Sathe from Pediatric Gastroenterology. The center provides a comprehensive team approach to this complex and chronic disease. It is actively involved in many national multicenter trials, 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. We are also founding members of the CF Learning Network and participate in the national Success with Therapies Research Consortium.
- Pediatric Sleep Program – under the direction of 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 (CBTi). Two PAP specialists provide mask fitting sessions and expertise for other equipment-related issues. Our 24-bed sleep lab (divided between 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.
- Dr. Princy Ghera, along with Dr. Esra Caylan who recently joined the team, conduct specialized clinics on neuromuscular and chest wall related respiratory diseases. Elisa Basora, M.D., and Michelle Caraballo, M.D., continue to participate in a multidisciplinary clinic for young patients with Duchenne’s Muscular Dystrophy. Also, as Dr. Ghera is Internal Medicine and Pediatrics trained, she has an interest in helping us develop a transition to adult medicine clinic for our patients with neuromuscular disorders. Lastly, Dr. Peter Luckett continues to help with the management of some of our adolescent patients with neuromuscular disease.
- In 2021, under the leadership of Dr. Yadira Rivera-Sanchez, we became the only accredited center by the Primary Ciliary Dyskinesia (PCD)Foundation for the diagnosis and treatment of patients with Primary Ciliary Dyskinesia in the North Texas region. We are working towards this clinic having a multidisciplinary approach so that we can better manage the needs of patients with PCD. Our clinic is the only clinic in North Texas able to perform nasal nitric oxide testing as a screening tool for the identification of patients with PCD.
- In 2015, Dr. Devika Rao founded a Pulmonary-Sickle Cell interdisciplinary clinic to address pulmonary needs of children with sickle cell anemia. This clinic takes place at the Pauline Allen Gill Center for Cancer and Blood Disorders once each month.
- Devika Rao, M.D., serves as Director of the Pulmonary Function Lab, Children’s Health until recently. The pulmonary function lab has greater than 1,000 visits per month. We have a fully functioning lab with the ability to do spirometry, body plethysmography, FeNO, methacholine and exercise challenges, and other measures of pulmonary function.
- Dr.Princy Ghera participates in Aerodigestive Multidisciplinary Clinic, which is conducted with the pediatric otolaryngology and gastroenterology services.
- Drs. Yadira Rivera-Sanchez and Tanya Martinez-Fernandez co-direct the High-Risk Asthma clinic. Dr. Folashade Afolabi contributes to this clinic as well. This multidisciplinary clinic is improving the care to some of our most serious patients with life threatening asthma. We recently expanded to expand this clinic by incorporating allergy, nutrition, social work, and physical therapy by and now function as a true multidisciplinary clinic for this fragile population.
- Andrew Gelfand, M.D., directs the ventilator clinic. This is a multidisciplinary clinic involving ENT, Physiatry, respiratory therapy, nursing, social work, radiology, nutrition, and case management. Here we follow over 200 patients with chronic mechanical ventilator needs from a variety of causes such as bronchopulmonary dysplasia, neuromuscular weakness, congenital heart disease, high spinal cord injury, neurologically impaired children with poor control of breathing as well as other causes of respiratory insufficiency. Dr. Folashade Afolabi formally joined the chronic ventilation team this past year. Drs. Steven Copenhaver and Pravin Sah who are associated with Children’s Health, also help with the management of these patients.
- Dr. Preeti Sharma directs the Hereditary Hemorrhagic Telangiectasia (HHT) clinic. She has partnered with the adult HHT center, Interventional Radiology, Hematology, and Gastroenterology to provide ease of care and increased benefit to these patients.
- Aarti Shakkottai started a Post Covid Respiratory clinic with the help of social work, psychology, and physical therapy this year to help with patients affected by SARS-COV-2 virus.
Children’s Medical Center was ranked 21st nationally in Pediatrics Pulmonology by U.S. News & World Report in 2022