The multidisciplinary Washington University Division of Pediatric Allergy, Immunology, and Pulmonary Medicine at St. Louis Children’s Hospital is a premier academic program, and its commitment to excellence in patient care, teaching, and research was recognized by our inclusion as one of America’s best pulmonary services, according to Parent magazine’s 2008 survey and the 2009 US & World Report Best Hospitals ranking. Nine (9) faculty members from the Division were listed as Best Doctors in America® this year. The Division supports an active clinical practice, and our faculty and nurse practitioners saw over 8500 outpatient visits at all sites last year, including nearly 2,500 new patient referrals and outpatient consultations. Inpatient clinical volumes and consultations have also grown following the creation of the 7 East Respiratory Unit at St. Louis Children’s Hospital.

 

Asthma care and research are prominent activities of the division. More than 450 children and adolescents with asthma are routinely followed in Pediatric Asthma Clinic, which is fully staffed by physicians, nurse practitioners, and skilled nurses. Over 1,200 children are admitted to St. Louis Children's Hospital each year for care of status asthmaticus, and many receive care by Division physicians and advanced practice nurses who are involved in the state-of-the-art Asthma Intervention Model (AIM). The Community Asthma Program continues to expand, focusing on asthma care in primary care settings with the goal to reduce hospitalizations and emergency visits, as well as improving quality of life for children with asthma and their families.  Management of children with allergies is an important part of the Division’s clinical activities. Faculty physicians see many children with rhinitis, sinusitis, eczema, urticaria, and other atopic disorders. In addition, the division offers penicillin and food allergy testing and treatment. Patients can be referred for clinical evaluation by calling our office at (314) 454-2694.   

Faculty in the Pediatric Asthma Center at St. Louis Children’s Hospital are leading multiple National Institutes of Health-supported pediatric asthma initiatives, including Childhood Asthma Research and Education Network (CARE), Childhood Asthma Management Program (CAMP), and Inner City Asthma Consortium, that are helping us understand the benefits and long-term effects of asthma treatment in children. Division faculty also developed of the Social Support and Education for Asthma program, in which coaching is provided to overcome barriers that interfere with asthma care delivery in urban communities and a multidisciplinary program focused on reducing asthma associated morbidities and mortality among children with sickle cell disease, Asthma and Nocturnal Hypoxemia in Sickle Cell Anemia.   

 

Caring for patients with cystic fibrosis for almost five decades, the comprehensive, fully accredited Cystic Fibrosis Center at Washington University Medical Center continues to thrive. The comprehensive, fully accredited Cystic Fibrosis Center at St. Louis Children’s Hospital supports premier clinical and research programs in cystic fibrosis.  Located at the St. Louis Children’s Hospital, the Pediatric Cystic Fibrosis Clinical Center has steadily increased in size, and we now see more than 230 children and adolescents regularly. In addition, we are involved in the care of cystic fibrosis patients from across the United States who have been referred for or benefited from lung or liver transplantation.  Referrals should be made through the Division office at (314) 454-2694.     

The Cystic Fibrosis Center is a member of the Cystic Fibrosis Foundation Therapeutics Development Network and one of six primary sites of the National Institutes of Health-supported Genetic Disorders of Mucociliary Clearance Consortium, a clinical research network to study rare diseases of the airways, focusing on variant forms of cystic fibrosis.  The Center has close collaborative relationships with Washington University investigators in clinical and basic science departments, which has allowed us to consider questions fundamental to our understanding of the disease. National Institutes of Health-funded investigators are working together on projects that deal with host-pathogen interactions, pulmonary inflammation, diabetes, and hepatic disease.  Center investigators continue their relationships with the Washington University Genome Sequencing Center and the Mallinckrodt Institute of Radiology that will advance our understanding of the basic defects in cystic fibrosis and translated to patient care.    

The Center produces newsletters for patients and families, and supports Cystic Fibrosis Parents Night Out and monthly Cystic Fibrosis Parent Networking Group for families of cystic fibrosis children.  As part of our quality improvement efforts, we created an active Parent Advisory Committee five years ago that has been a valuable resource, providing ideas for improvement of inpatient and outpatient cystic fibrosis care.    

 

St. Louis Children's Hospital continues to be one of the most active pediatric solid organ transplant centers in the United States.  The Washington University School of Medicine and St. Louis Children's Hospital pediatric lung transplant program was the first free-standing pediatric lung transplant program, and over 300 lung and heart-lung transplants have been performed here. The program remains the preeminent pediatric lung transplant program in the world, with referrals from across North America and worldwide. The transplant pulmonologists work closely with cardiothoracic surgeons, pediatric intensivists, and clinical staff to provide the best pre- and post-operative care of children with advanced lung diseases.  The National Institutes of Health recognized the leadership role of our pediatric lung transplantation program in 2007, when after a highly competitive grant review process, it selected this Division to lead the first ever international network of academic children’s hospitals focused on understanding the mechanisms that lead to rejection in these patients, Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation.   

 

In addition to the conditions described above, the Division faculty and nurses treat a variety of less common pediatric lung disorders, including alveolar proteinosis, pulmonary hemosiderosis, bronchopulmonary dysplasia, bronchiolitis obliterans, interstitial pneumonitis, primary ciliary dyskinesia, tracheobronchomalacia, vocal cord dysfunction, aspiration disorders, hypersensitivity pneumonitis, and a variety of lung diseases associated with neuromuscular disorders. Patients can be referred for clinical evaluation by calling our office at (314) 454-2694.   
 

The Pediatric Pulmonary Function Laboratory at St. Louis Children's Hospital specializes in pediatric testing from infancy through adolescence. The laboratory offers a full range of lung function tests for clinical and research patients, from infancy into early adulthood. In addition to standard tests of lung mechanics and function (including spirometry, plethysmography, maximal respiratory pressures, and diffusion capacity measures), the laboratory conducts specialized tests including cardiopulmonary studies, resting metabolics, and bronchoprovocation tests. The lab also performs state-of-the-art infant pulmonary function testing including plethysmographic measurements of lung volume and raised-volume forced flows. The laboratory routinely performs over 7000 tests annually.    

 

Pediatric pulmonologists attend our bronchoscopy center, where more than two hundred procedures are performed annually. Flexible fiberoptic bronchoscopy is an active service of excellence offered by our skilled bronchoscopists. Most procedures are performed in the convenient Ambulatory Procedure Center, and are usually performed on an out-patient basis. Depending on the indication, bronchoalveolar lavage and transbronchial biopsy can be obtained during the procedures. Indeed, because of our extensive experience with lung transplantation, methods of performing biopsies in infants have been developed and have established our center as the leader in the field.  Referrals should be made through the Division office at (314) 454-2694.    

 

The multidisciplinary Washington University Division of Pediatric Allergy, Immunology, and Pulmonary Medicine at St. Louis Children’s Hospital is a premier academic program, and its commitment to excellence in patient care, teaching, and research was recognized by our inclusion as one of America’s best pulmonary services, according to Parent magazine’s 2008 survey and the 2009 US & World Report Best Hospitals ranking. Nine (9) faculty members from the Division were listed as Best Doctors in America® this year. The Division supports an active clinical practice, and our faculty and nurse practitioners saw over 8500 outpatient visits at all sites last year, including nearly 2,500 new patient referrals and outpatient consultations. Inpatient clinical volumes and consultations have also grown following the creation of the 7 East Respiratory Unit at St. Louis Children’s Hospital.

 

Asthma care and research are prominent activities of the division. More than 450 children and adolescents with asthma are routinely followed in Pediatric Asthma Clinic, which is fully staffed by physicians, nurse practitioners, and skilled nurses. Over 1,200 children are admitted to St. Louis Children's Hospital each year for care of status asthmaticus, and many receive care by Division physicians and advanced practice nurses who are involved in the state-of-the-art Asthma Intervention Model (AIM). The Community Asthma Program continues to expand, focusing on asthma care in primary care settings with the goal to reduce hospitalizations and emergency visits, as well as improving quality of life for children with asthma and their families.  Management of children with allergies is an important part of the Division’s clinical activities. Faculty physicians see many children with rhinitis, sinusitis, eczema, urticaria, and other atopic disorders. In addition, the division offers penicillin and food allergy testing and treatment. Patients can be referred for clinical evaluation by calling our office at (314) 454-2694.   

Faculty in the Pediatric Asthma Center at St. Louis Children’s Hospital are leading multiple National Institutes of Health-supported pediatric asthma initiatives, including Childhood Asthma Research and Education Network (CARE), Childhood Asthma Management Program (CAMP), and Inner City Asthma Consortium, that are helping us understand the benefits and long-term effects of asthma treatment in children. Division faculty also developed of the Social Support and Education for Asthma program, in which coaching is provided to overcome barriers that interfere with asthma care delivery in urban communities and a multidisciplinary program focused on reducing asthma associated morbidities and mortality among children with sickle cell disease, Asthma and Nocturnal Hypoxemia in Sickle Cell Anemia.   

 

Caring for patients with cystic fibrosis for almost five decades, the comprehensive, fully accredited Cystic Fibrosis Center at Washington University Medical Center continues to thrive. The comprehensive, fully accredited Cystic Fibrosis Center at St. Louis Children’s Hospital supports premier clinical and research programs in cystic fibrosis.  Located at the St. Louis Children’s Hospital, the Pediatric Cystic Fibrosis Clinical Center has steadily increased in size, and we now see more than 230 children and adolescents regularly. In addition, we are involved in the care of cystic fibrosis patients from across the United States who have been referred for or benefited from lung or liver transplantation.  Referrals should be made through the Division office at (314) 454-2694.     

The Cystic Fibrosis Center is a member of the Cystic Fibrosis Foundation Therapeutics Development Network and one of six primary sites of the National Institutes of Health-supported Genetic Disorders of Mucociliary Clearance Consortium, a clinical research network to study rare diseases of the airways, focusing on variant forms of cystic fibrosis.  The Center has close collaborative relationships with Washington University investigators in clinical and basic science departments, which has allowed us to consider questions fundamental to our understanding of the disease. National Institutes of Health-funded investigators are working together on projects that deal with host-pathogen interactions, pulmonary inflammation, diabetes, and hepatic disease.  Center investigators continue their relationships with the Washington University Genome Sequencing Center and the Mallinckrodt Institute of Radiology that will advance our understanding of the basic defects in cystic fibrosis and translated to patient care.    

The Center produces newsletters for patients and families, and supports Cystic Fibrosis Parents Night Out and monthly Cystic Fibrosis Parent Networking Group for families of cystic fibrosis children.  As part of our quality improvement efforts, we created an active Parent Advisory Committee five years ago that has been a valuable resource, providing ideas for improvement of inpatient and outpatient cystic fibrosis care.    

 

St. Louis Children's Hospital continues to be one of the most active pediatric solid organ transplant centers in the United States.  The Washington University School of Medicine and St. Louis Children's Hospital pediatric lung transplant program was the first free-standing pediatric lung transplant program, and over 300 lung and heart-lung transplants have been performed here. The program remains the preeminent pediatric lung transplant program in the world, with referrals from across North America and worldwide. The transplant pulmonologists work closely with cardiothoracic surgeons, pediatric intensivists, and clinical staff to provide the best pre- and post-operative care of children with advanced lung diseases.  The National Institutes of Health recognized the leadership role of our pediatric lung transplantation program in 2007, when after a highly competitive grant review process, it selected this Division to lead the first ever international network of academic children’s hospitals focused on understanding the mechanisms that lead to rejection in these patients, Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation.   

 

In addition to the conditions described above, the Division faculty and nurses treat a variety of less common pediatric lung disorders, including alveolar proteinosis, pulmonary hemosiderosis, bronchopulmonary dysplasia, bronchiolitis obliterans, interstitial pneumonitis, primary ciliary dyskinesia, tracheobronchomalacia, vocal cord dysfunction, aspiration disorders, hypersensitivity pneumonitis, and a variety of lung diseases associated with neuromuscular disorders. Patients can be referred for clinical evaluation by calling our office at (314) 454-2694.   
 

The Pediatric Pulmonary Function Laboratory at St. Louis Children's Hospital specializes in pediatric testing from infancy through adolescence. The laboratory offers a full range of lung function tests for clinical and research patients, from infancy into early adulthood. In addition to standard tests of lung mechanics and function (including spirometry, plethysmography, maximal respiratory pressures, and diffusion capacity measures), the laboratory conducts specialized tests including cardiopulmonary studies, resting metabolics, and bronchoprovocation tests. The lab also performs state-of-the-art infant pulmonary function testing including plethysmographic measurements of lung volume and raised-volume forced flows. The laboratory routinely performs over 7000 tests annually.    

 

Pediatric pulmonologists attend our bronchoscopy center, where more than two hundred procedures are performed annually. Flexible fiberoptic bronchoscopy is an active service of excellence offered by our skilled bronchoscopists. Most procedures are performed in the convenient Ambulatory Procedure Center, and are usually performed on an out-patient basis. Depending on the indication, bronchoalveolar lavage and transbronchial biopsy can be obtained during the procedures. Indeed, because of our extensive experience with lung transplantation, methods of performing biopsies in infants have been developed and have established our center as the leader in the field.  Referrals should be made through the Division office at (314) 454-2694.