The Children’s Lung, Asthma & Sleep Specialists is a highly specialized private practice dedicated in the management of a broad range of pediatric pulmonary disorders. In addition, the practice provides special programs and services to address specific patient needs.
Asthma Center of Excellence
The practice runs an asthma program that is geared towards the patient and parent achieving a full understanding of the asthma and improving patient management. In addition, our Asthma Center of Excellence program focuses on providing high quality, most comprehensive service for children and adolescents with difficult-to-treat or severe asthma. The main objective of the program is to reduce asthma related mortality and morbidity including hospitalizations, emergency department visits, missed school days, and activity limitations.
Severe or difficult-to-treat asthma is characterized by ongoing symptoms and frequent severe exacerbations despite treatment with high doses of inhaled corticosteroids and/or need for systemic corticosteroids. Although the prevalence of severe or difficult-to-treat asthma estimated to account only for about 10% asthma patients, it contributes for a significant share of asthma related poor outcomes. Despite advances in asthma therapy over the last few decades, a significant proportion of children with asthma continue to suffer from suboptimal asthma control.
Our asthma program utilizes pediatric pulmonologists with extensive knowledge in asthma diagnosis and management. We provide high quality evidence based therapy for all children with asthma with particular focus on difficult-to-treat or severe asthma.
The cardinal goals of the program are to:
- Diagnose and characterize the severity of the disease in the patient.
- Ensure that patients and parents understand asthma, its cause, and management.
- Identify, treat and where possible modify the environment to decrease the impact of allergies on the child
- Give patient and parents acceptable expectations for daily life such as improving exercise tolerance in children, decreasing the incidence of coughing and preventing the onset of a sedentary or inactive lifestyle
- Decrease the duration and severity of respiratory illnesses by instituting an anticipatory management program that decreases the likelihood of acute asthma attacks or prolonged colds.
- Improve quality of life by decreasing incidences of nocturnal symptoms, which may affect the quality of sleep in the patient, as well as decreasing sick days or missed school days
- Establish an active partnership with primary care physicians by identifying at- risk population and providing asthma-related education services
- Provide primary care physician with an easy screening tool (Tab. 1) that enables them to identify children and adolescents with difficult-to-treat or severe persistent asthma
Table 1: An easy-to-use screening tool for Severe or Difficult-to-treat asthma
Has your child been diagnosed with asthma? Yes No
Please answer the following questions regarding your child
|1||Does your child have asthma symptoms (cough) every day or require albuterol-breathing treatments every day for asthma symptoms.||□||□|
|2||Does your child have extreme limitations due to asthma symptoms (coughing or shortness of breath with exercise)?||□||□|
|3||Does your child have nighttime coughing two or more nights a week?||□||□|
|4||Has your child needed two or more courses of oral steroids (PreloneÒOrapredÒ, prednisone) in the last 6 months?||□||□|
|5||Has your child had two or more ahospitalizations for asthma in the last year?||□||□|
|6||Has your child ever had any hospital stays in the ICU for asthma?||□||□|
|7||Does your child ever miss school or daycare more than once a month due to asthma attacks?||□||□|
|8||Does your child use three or more of the listed asthma medications? (example— SingulairÒ, FloventÒ, PulmicortÒ, AdvairÒ, Q-varÒ, DuleraÒ, SymbicortÒ, oral steroids)||□||□|
|If you answered yes to one or more of these questions, your child has moderate to severe asthma and would benefit from evaluation in our asthma program.|
High-Risk Infant and Preterm Infant Program
This is a specialized program with the primary goal of preventing or minimizing long-term respiratory consequences of preterm birth as well as severe respiratory disease in preterm infants and high-risk full term infants.
Chronic lung disease (CLD) of infancy represents the final common pathway of a heterogeneous group of pulmonary disorders that start in the neonatal period. CLD of infancy results from lung injury related prematurity, surfactant deficiency, use of high concentrations of oxygen and mechanical ventilation. With increased survival extremely premature and very low birth weight infants, the prevalence of CLD of infancy has been rising. Depending on the severity of the disease, some of these infants may be discharged home from the hospital on supplemental oxygen or even with tracheostomy tubes and home ventilators. They remain at high risk for pulmonary morbidity and mortality from repeated pulmonary infection during the first 2 years of life
The emphasis of our High-Risk Infant and Preterm Infant Program focuses on disease prevention and aggressive management of high-risk conditions such as apnea, wheezing in infancy, and gastroesophageal reflux disease/aspiration syndrome. The practice also runs an RSV prophylaxis program and administers SynagisTM.