DEPARTMENT OF PEDIATRIC PULMONOLOGY

Respiratory illnesses are the common reasons for hospital visit in children, constituting nearly 30% of the total. Chronic respiratory illnesses such as cystic fibrosis, interstitial lung diseases, bronchiectasis chronic aspiration and aerodigestive problems are adding morbidity in them. The scope of establishing the department “Pediatric Pulmonology” with advanced and dedicated lab facility was to give focussed, exemplary evidence – based, multidisciplinary respiratory care to the children suffering from both acute and chronic respiratory problems with the improved quality. The Pediatric pulmonology team is supported by anaesthesia, ENT, pediatric surgery and physiotherapy departments.

1. PULMONOLOGY CLINICAL SERVICES

We provide comprehensive care to the children with following respiratory problems

• Wheezing in children less than 5 years
• Childhood Asthma
• Allergic rhinitis and adenoid related problems
• Pneumonia, Complicated pneumonia and Pleural diseases
• Airway problems – airway malacia, narrowing
• Tuberculosis - chest & other organs
• Suppurative lung diseases – cystic fibrosis, Primary Ciliary Dyskinesia etc
• Interstitial lung diseases – Bronchiolitis Obliterans, Broncho Pulmonary Dysplasia, child
• Immunodeficiency with chest infections
• Chronic aspiration syndrome, aero digestive problems
• Respiratory problems due to neuromuscular diseases, rheumatological diseases, post bone marrow transplant
• Congenital lung problems – post surgery follow up care
• Sleep related problems – snoring, obstructive sleep apnea, insomnia
• Other chronic lung diseases

2. PULMONOLOGY LAB SERVICES

The pulmonology lab with state of art facilities for diagnosis and assessment of therapeutic response have been inaugurated a year back. The following facilities are available at KKCTH

• Forced oscillometry – a lung function test can be used in children aged > 4 years to diagnose smaller airway problems and also helps to guide for optimizing the therapy.
• FeNO – recently established test to support the diagnosis and to monitor therapy in asthma. Simple test can be done in any child > 6 years.
• Nasal NO – screening test for the genetic disorder primary ciliary dyskinesia, done for children > 5 years.
• Nocturnal oximetry – to initiate and to optimize home oxygen therapy, part of sleep study.
• Polysomnogram – level 2 & 3 sleep evaluation to diagnose sleep related problems. The sleep study helps to decide on management for children with obstructive sleep apnea (need for surgery or home ventilation).

3. DIAGNOSTIC AND INTERVENTIONAL BRONCHOSCOPY SERVICES

Bronchoscopy services are being done safely with anaesthesia team support in children as small as weighing 2 kg to adolescent age group whenever required. All the consultants performing bronchoscopy at KKCTH are well trained in doing the procedure as well as managing complications if any.

Bronchoscopy is useful to diagnose structural problems in the airway. Bronchial washing obtained during the procedure helps to identify the infections and helps to diagnose certain lung diseases. Therapeutic lavage is also being done for children.

Recently, new diagnostics such as endobronchial biopsy and endobronchial needle aspiration procedures through bronchoscopy have been started. Foreign body in the airways (such as peanut, plastics articles) of toddlers are routinely being removed using flexible bronchoscopy, with rigid bronchoscopy backup.

Interventional pulmonology has been a latest addition to the bronchoscopy services at KKCTH.

4. ACADEMIC SERVICES

The institute has been selected as one of the training centres for Pediatric Pulmonology from the year 2023. Pulmonology fellow or Pediatrician is available 24*7 for managing new as well as follow up children in case of any emergency.

Pulmonology department have been conducting bronchoscopy workshop with Dr Vijayasekaran as course director for many years. KKCTH is one of the institutions where regular yearly bronchoscopy workshop was started much earlier and leading the way forward in training young pulmonology fellows and pediatricians with special interest in pulmonology to do bronchoscopy in children. Many of them established their own bronchoscopy centres at their places all over the country.

The department is recognized by IAP NRC (India Academy of Pediatrics – National Respiratory Chapter), New Delhi, for the 2 years National Board fellowship accredited by Indian college of Pediatrics (ICP).

It is the only institute in our state to provide two years dedicated and intense training in the field of Pediatric Pulmonology. Only 10 centres in the country are recognized for the fellowship program and KKCTH is being the recent addition.