The Division of Pediatric Pulmonology, Allergy and Sleep Medicine at IU School of Medicine provides clinical care for patients and education for students, residents and fellows in state-of-the-art facilities with modern technology and equipment.
Pulmonary Diagnostic Center
The Pulmonary Diagnostic Center encompasses the Pediatric Pulmonary Function Laboratory and the Infant/Preschool Testing Laboratory. The Pediatric Pulmonary Function Laboratory performs pulmonary function testing for infants through adulthood for physicians throughout Indiana. The lab is staffed by a team of respiratory therapists specially trained in performing pulmonary function measurements, including spirometry in children, with particular expertise in performing infant and preschool lung function testing (with or without bronchodilator). Other tests include exhaled Nitric Oxide (eNO), bronchial provocation (methacholine and mannitol), exercise challenge, exercise bronchoscopy, plethysmography, lung volumes and diffusion capacity.
The Infant/Preschool Testing Laboratory at this facility performs infant pulmonary function testing using the raised volume technique. This is the only lab of its type in Indiana and the only laboratory in the world capable of measuring diffusion capacity in infants. Preschool pulmonary function testing includes forced oscillometry and measurement of the lung clearance index using multiple breath washout.
The center’s metabolic and exercise testing laboratory is available to physicians throughout Indiana to help evaluate the cause of a child’s breathing problems. Flexible bronchoscopy services are also available to evaluate for possible abnormalities of the upper and lower airways and to obtain lavage fluid for testing of possible infection (bronchoalveolar lavag). Bronchoscopies are performed in the Riley Outpatient Center (ROC) Surgery or throughout the Riley inpatient procedure centers.
The pediatric bronchoscopy team coordinates procedures with families, referring providers, anesthesiologists and sedation teams so as to provide the greatest comfort and care for patients. Faculty and trainees perform a high volume of procedures, and bronchoscopies are often done during other procedures in order to minimize general anesthesia for the patient.
Cystic Fibrosis Center
Nationally recognized for excellence in care, research and leadership, the Riley Cystic Fibrosis Center provides advanced care for children with Cystic Fibrosis and is Indiana’s only program accredited by the Cystic Fibrosis Foundation. A multidisciplinary team of physicians, advanced practice nurses, dietitians, nurses, respiratory therapists, social workers, psychologists, pharmacists and child life specialists work together to provide patient care.
Early diagnosis and care has been linked to improved outcomes for people with CF, and the Riley Cystic Fibrosis Center at IU School of Medicine is the core center for Indiana’s Cystic Fibrosis newborn screening program. The Center also provides oversight of outreach and satellite care centers throughout Indiana and supports a fully accredited Cystic Fibrosis Care Center for individuals 18 years and older.
Research at the Center has led to the development of many new therapies and improvements for Cystic Fibrosis care. Many of these clinical trials are supported by the Cystic Fibrosis Foundation and the National Institutes of Health.
Riley Asthma Care Center
The Riley Asthma Care Center’s pulmonary and allergy team provides high-quality patient-focused asthma care, shares information about new trends in asthma, and continually strives to better understand the impact of asthma on children’s lives. Board-certified pulmonologists and allergists, nurses, nurse practitioners, respiratory therapists, and certified asthma educators work together to provide the best and most comprehensive asthma care possible for children. Children who have asthma and visit this center for treatment undergo physical exams, lung functions tests and often allergy testing to help staff better determine the severity of the child’s condition and tailor a plan to best meet the child’s needs.
Since less than one percent of children with asthma require hospitalization for their asthma each year, children with asthma must have close follow up and monitoring after hospitalization. The Riley Asthma Care team provides this critical bridge between inpatient and outpatient management. The Riley Asthma Care team also partners with community outreach services to provide education and in-home evaluations throughout the state. These partnerships include county health departments, local and regional hospital systems, American Lung Association of Indiana, Indiana Joint Asthma Coalition, Indiana State Department of Health, and Annual School Nurse Symposium.
Riley High Risk Asthma Clinic
The Riley High Risk Asthma Clinic serves those patients with asthma that is difficult to control despite usual specialist treatment, such as multiple hospitalizations or a need for intensive care management. The High Risk Asthma Clinic team addresses adherence issues, aggressively adjusts medications as indicated, responds to asthma flares quickly, addresses social and financial needs, and provides ongoing asthma education at every clinic visit. Through an intensive team approach, the High Risk Asthma Clinic is able to decrease hospitalization rates for those children enrolled by 40-50 percent.
Children's Sleep Disorder Center
The Children’s Sleep Disorder Center, established in 1986, is one of the largest centers of its kind in the United States and the only dedicated pediatric sleep laboratory in Indiana. The Riley sleep disorders program has performed more than 50,000 sleep studies since its establishment.
This multidisciplinary program is staffed by board-certified sleep medicine physicians, three of whom are additionally certified in pediatric pulmonology and one in neurology. The program has two child psychologist with training in behavioral sleep medicine. Support staff includes nurses, respiratory therapists, and sleep technicians with expertise in performing high-quality sleep studies in children, ranging in age from newborns through adulthood. Patients receive care in a compassionate and a child-friendly environment.
The program offers management for patients on technology such as CPAP and Bilevel PAP, SIP ventilation, High Flow Nasal canula support and Biphasic Cuirass Ventilation. Sleep specialists work closely with surgical specialists, including otolaryngology, orthodontics, neurosurgery and craniofacial surgeons at Riley Hospital for Children to manage children with complex sleep apnea. Additional faculty physician interests include sleep disorders in children with autism and neuromuscular disorders.
Sleep disorders are common in childhood, with almost 20-40 percent of children having experienced a sleep disturbance at some point while growing up. A screening process for clinic appointments ensure each patient sees all the team members who can help address the child’s sleep concerns.
Center for Primary Ciliary Dyskinesia
The Center for Primary Ciliary Dyskinesia opened in February 2013 and serves as a diagnostic center for primary ciliary dyskinesia as part of Riley Hospital for Children’s Genetic Disorders of Mucociliary Clearance Research Consortium.
Primary Ciliary Dyskinesia, a rare disease of the airway, is difficult to diagnose and is often misdiagnosed. Patients with this autosomal recessive disease have abnormal cilia lining their airway, sinuses and ears. Patients may experience neonatal distress, chronic “wet” cough, chronic nasal congestion, and frequent infections of the lungs, ears, throat and sinuses. Chronic respiratory infections may result in irreversible lung changes including bronchiectasis. Approximately 50 percent of primary ciliary dyskinesia patients also have situs inversus. An estimated 400,000 individuals worldwide suffer from Primary Ciliary Dyskinesia, many undiagnosed.
The Division of Pulmonology, Allergy and Sleep Medicine cares for patients at the following sites:
- Riley Outpatient Center (705 Riley Hospital Drive, Indianapolis, IN 46202)
- Riley Specialists (4935 West Arlington Road, Suite A, Bloomington, IN 47404)
- St. Francis Hospital (5255 East Stop 11 Road, Suite 460, Indianapolis, IN 46237)
- Deaconess Hospital Pediatric Clinics (4033 Gateway Blvd., Suite 220, Newburg, IN 47630)
- Especially Kidz Health & Rehab Center (2325 South Miller Street, Shelbyville, IN 46176)
- Saxony (13100 E 136th Street, Suite 3600, Fishers, IN 46037)
- Riley Children’s Specialists (11590 Meridian Street, Suite 300, Carmel, IN 46032)
- Riley Children’s Health (415 East Cook Road, Fort Wayne, IN 46825)