New Specialty Multidisciplinary Clinics in the Division of Pediatric Pulmonary Medicine

The Division of Pediatric Pulmonary Medicine at UPMC Children’s Hospital of Pittsburgh has recently expanded its specialty clinic presence for patients with sickle cell disease (SCD), complex airway disorders, and patients with neuromuscular conditions.

These patient-centered, multidisciplinary clinics bring to bear the combined expertise of multiple Divisions and clinicians with clinical and research emphasis in these complex and challenging conditions. 

The integrated, multidisciplinary approach to these clinics affords patients and families with cohesive and comprehensive follow-up care across their spectrum of needs.

Sickle Cell Disease Clinic

Lung or pulmonary complications from sickle cell disease are common and contribute significantly to much of the morbidity and even mortalities associated with the disease. Often these complications begin in childhood, making screening and interventions for pulmonary complications and identifying risk factors in SCD patients critical to long-term health and disease management. Complications such as acute chest syndrome are common. Sickle cell disease patients are more prone to obstructive sleep apnea, which can trigger a sickle cell crisis due to reduced oxygen levels.

These patients also are more prone to recurrent wheezing than healthy children. All of these complications can devolve into a repetitive cycle that leads to poor outcomes if not well-managed. In adult sickle cell disease patients, pulmonary hypertension is a significant morbidity, and the processes for this manifestation later in life likely have their origins during childhood. Early interventions and optimal disease management may forestall or lessen the manifestation or future impacts of pulmonary hypertension as patients age.

Leading clinical pulmonary medicine efforts in the new multidisciplinary sickle cell disease clinic is Division clinical director Mark Dovey, MD. Dr. Dovey is joined by a pulmonary medicine nurse practitioner, John Broyles, and a respiratory therapist who assists with lung function testing and educational efforts. Dr. Dovey modeled this program on a similar clinic at St. Christopher’s Hospital for Children in Philadelphia, where he practiced before joining UPMC Children’s.

Dr. Dovey's team joins the hematology team, which runs the Comprehensive Pediatric Sickle Cell Program in the Division of Pediatric Hematology/Oncology, led by Cheryl A. Hillery, MD, and Ramasubramanian Kalpatthi, MD.

"The average life span for sickle cell patients is significantly less than the general population, and direct lung complications or associated morbidities account for many of these mortalities. By integrating focused pulmonary care into the sickle cell clinic, we can capture more of these patients earlier in the disease process and work to optimize their lung function and long-term health as best as possible," says Dr. Dovey.

The clinic operates two days each month, and the pulmonary team component officially launched in mid-2021.

Airway Disorders Clinic

The updated Airway Disorders clinic combines specialists from otolaryngology, speech-language pathology, and pulmonary medicine to care for patients with complex congenital anomalies or diseases of the airway. These patients often exhibit problems with feeding and swallowing issues, and at times issues with speech, in addition to their surgical and pulmonary medicine needs.

Pediatric pulmonary medicine specialist Geoffrey Kurland, MD, leads the pulmonary medicine efforts in the Airway Disorders Clinic. In addition to general pulmonary medicine consultation work, Dr. Kurland performs flexible bronchoscopy procedures as part of the multidisciplinary care approach.

For children born with complex congenital airway anomalies, this combined approach to follow-up care is the most efficient and effective form of care, as is the case for patients who manifest and must overcome feeding struggles as a consequence of their pulmonary or breathing comorbidities. The clinic currently operates twice per month to provide comprehensive patient care for a diverse group of patients. 

Multidisciplinary Care for Neuromuscular Patients

Jane B. Taylor, MD, MsCR, FAAP, is the pulmonary medicine liaison for the UPMC Children's multidisciplinary pediatric Muscular Dystrophy Association clinic (MDA Clinic). Dr. Taylor joined the Division in late-2019 and subsequently launched the pulmonary component of the MDA clinic in 2020. Dr. Taylor has a passion for pulmonary management in children with neuromuscular disorders and participated as the pulmonary medical director in the multidisciplinary muscular dystrophy clinic in Kansas City prior to her joining UPM Children’s. Dr. Taylor currently sits on the medical advisory council for CureSMA and is an active participant with the Parent Project Muscular Dystrophy (PPMD).

Learn more about the UPMC Children’s pediatric pulmonary medicine specialty clinics and attending faculty by visiting CHP.edu.