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Clinical Care

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 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.

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.

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.

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.

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.

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 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.

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.

Bronchoalveolar Lavage Laboratory

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.