Physicians in the Division of Pulmonary Medicine at IU School of Medicine care for patients in state-of-the-art facilities alongside highly trained staff. Faculty physicians in this specialty area provide general pulmonary and critical care services across the Indianapolis campus in primarily closed ICU settings, including 24/7 in-house critical care services at IU Health University and Methodist hospitals.
Focus Areas
The division has developed certain focus areas in patient care, blending clinical skills with cutting-edge research and education of future clinicians and scientists. As a result of its commitment to patient care and ability to provide disease-focused programs, this division was recognized by U.S. News and World Report as the 14th best pulmonary and critical care program in the United States.
The Bronchoalveolar Lavage Laboratory, a CLIA-certified facility located on the IU School of Medicine—Indianapolis campus, provides analysis of bronchoalveolar lavage cells through performance of differential counts, lymphocyte phenotyping, hemosiderin staining for assessment of alveolar hemorrhage and screening for histiocytosis X.
As more patients with cystic fibrosis survive to adulthood, a need exists for these patients to transition from pediatric care into the care of pulmonologists who care for adults. Pulmonary Medicine division faculty provide a clinic dedicated to the care of patients with CF and currently follow more than 150 adults with CF who travel to Indianapolis from the Midwest United Stated. This is an accredited care center through the Cystic Fibrosis Foundation (CFF), and investigators participate in clinical research trials through a partnership with the CFF Therapeutic Development network.
The pulmonary faculty physicians at IU School of Medicine were among the first to recognize that patients in the ICU suffer many early and late cognitive impairments, including delirium and post-traumatic stress disorder, and this team of specialistshas been leading research in this area. IU School of Medicine is one of the few academic health centers in the United States that has an established clinic to treat patients who have survived an ICU stay.
The Department of Medicine’s Pulmonary Medicine Division collaborates with several partners to develop specialized programs to care for patients with immunologic lung disease. All physicians are board-certified pulmonologists with special interest and expertise in interstitial and immunologic disorders of the lung. This program offers education for patients, trainees and physicians, diligent monitoring of treatment side effects, novel treatments and research protocols for eligible patients, a CLIA-certified bronchoalveolar lavage laboratory offering lung cell sub-typing and a full profile of medical services dedicated to the proper diagnosis of immunologic lung diseases.
Pulmonologists at IU School of Medicine provide care for
patients throughout the lung cancer spectrum, from those at risk to those
diagnosed with and on treatment for lung cancer.
Many patients have lung diseases that result in chronic respiratory failure. These diseases include neuromuscular diseases, including amyotrophic lateral sclerosis and end-stage COPD or pulmonary fibrosis. In addition to managing the underlying disease processes, these patients and their families also frequently require specialized care to manage ventilatory assist devices (CPAP, BIPAP, ventilators) at home. In collaboration with members of the IU School of Medicine Department of Neurology, the Pulmonary division faculty run the Neuromuscular Pulmonary Clinic to help patients with these devastating diseases lead as normal lives as possible in the outpatient environment.
The Occupational Lung Disease Center specializes in evaluating patients with suspected occupational lung disease and is a collaboration between pulmonologists and radiologists evaluating patients with suspected occupational lung disease.
Patients with all types of pulmonary hypertension (WHO groups 1-5) are actively evaluated and treated in the Pulmonary hypertension clinics within the Advanced Heart and Lung Disease Center at IU Health Methodist Hospital and at the Roudebush VA Medical Center. All faculty physicians are board-certified pulmonologists with special interest and expertise in pulmonary vascular disease and hemodynamic evaluation. Faculty work closely with their colleagues in cardiology, rheumatology, gastroenterology/hepatology, radiology and thoracic surgery to provide the best possible interdisciplinary training and patient care.
Modern diagnostic modalities, including cardiac MRI and cardiopulmonary exercise testing, are available. Treatment modalities include oral drugs (endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase activator) as well as inhaled, subcutaneous and intravenous medications (prostacyclins and inhaled nitric oxide). Clinics offer mechanical and surgical rescue therapies (e.g., ECMO and eatrial septostomy) and provide special expertise in employing exercise as a therapeutic intervention in the treatment of right ventricular failure.
Specialized programs for care of patients with sarcoidosis is offered by facultyphysicians in the Division of Pulmonary Medicine; all are board-certified pulmonologists with special interest and expertise as sarcoidologists. This program includes patient and physician education, diligent monitoring of treatment side effects, novel treatments, and research protocols for eligible patients. A CLIA-certified bronchoalveolar lavage laboratory is also available for lung cell sub-typing and a full profile of medical services dedicated to the proper diagnosis of immunologic lung diseases.
The Sleep Medicine and Circadian Biology Program at IU School of Medicine offers specialized services for individuals who have sleep-related problems. This program is the focal point for several different subspecialties to advance state-of-the-art methods and emerging research to patient care. Subspecialties involved in the program include pulmonary medicine, neurology, otolaryngology, oral-maxillofacial surgery, psychiatry and dentistry. The program now has the capacity to house two sleep medicine fellowships per year. The clinic is affiliated with the IU Health Sleep Disorders Center, an eight-bed facility that has been evaluating patients since 1988.
Faculty in the News
Alan Hyslop, MD, was recently interviewed by CNN in relation to the pope's respiratory illness and ICU admission.
"Anybody who comes into the hospital, whether they're old or young, they're at certainly higher risk of death if they're coming in with respiratory failure. And certainly as you get older, become more frail, it certainly becomes harder for you to even be supported with a ventilator and make it out OK unscathed. When someone has pneumonia or respiratory infection, when you come into the hospital or are placed on any sort of oxygen delivery device, whether it be a nasocannula or some sort of heated high flow device or even a non-invasive mechanical ventilating device such as an oxygen mask or BiPAP, we treat you with oxygen, we treat you with antibiotics. And certainly if you fail those supportive measures, then we turn to mechanical ventilation, which it sounds like the pope has been placed upon. When someone has a buildup of secretions or mucus in their airways, sometimes the antibiotics and even the ventilator are not enough to help clear the airway so that we can provide enough oxygen and ventilate efficiently enough for the body to get rid of the carbon dioxide. And when that happens, sometimes the physician or the provider who's taking care of the patient may have to perform procedure called a bronchoscopy in which they place a tube with a camera and a light source at the end of it. And they go down, look into the lungs and remove as much mucus or phlegm that is down there to help the patient breathe better. In any case in which someone who is able to come off the breathing machine or able to transition down from having invasive ventilator support to a non-invasive, that's always a step in the right direction in the case of respiratory failure. However, in the pope's case, for instance, you know, having vomiting or emesis into a mask certainly puts you at higher risk of aspiration or, you know, contents that are coming from the stomach into your lower airways, which causes further inflammation and further risk of infection. And certainly that's not a good direction to head in." —Alan Hyslop, MD
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