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Article ; Online: The history of workforce concerns in pediatric pulmonary Medicine.

Oermann, Christopher M / Lahiri, Thomas / Peterson-Carmichael, Stacey L / Weiss, Pnina

2020 Volume 58, Issue 3, Page(s) 683–689

Abstract: Children are affected by a broad spectrum of acute and chronic respiratory disorders. The number of children with respiratory disease is increasing, as are the complexity of disease pathophysiology and the management demands on pediatric pulmonologists. ... ...

Abstract	Children are affected by a broad spectrum of acute and chronic respiratory disorders. The number of children with respiratory disease is increasing, as are the complexity of disease pathophysiology and the management demands on pediatric pulmonologists. Despite slowly increasing numbers of board-certified pediatric pulmonologists, large areas of the country are underserved and there is a perception of an impending workforce crisis. There are multiple reasons for these concerns. A joint effort between the Pediatric Pulmonology Division Directors Association and Pediatric Pulmonary Training Directors Association was undertaken to address these issues.
MeSH term(s)	Humans ; Child ; United States ; Pulmonary Medicine/education ; Workforce ; Certification ; Fellowships and Scholarships
Language	English
Publishing date	2020-10-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.25094
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Article ; Online: The future of pediatric pulmonology: A survey of division directors, assessment of current research funding, and discussion of workforce trends.

Noah, Terry L / Tolleson-Rinehart, Sue / Esther, Charles R / Peterson-Carmichael, Stacey L / Davis, Stephanie D / Moore, Paul E

Pediatric pulmonology

2021 Volume 58, Issue 3, Page(s) 653–661

MeSH term(s)	Child ; Humans ; United States ; Pulmonary Medicine ; Workforce ; Surveys and Questionnaires
Language	English
Publishing date	2021-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.25228
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Article ; Online: Lung clearance index in children with sickle cell disease.

Machogu, Evans M / Khurana, Monica / Kaericher, Jennifer / Clem, Charles C / Slaven, James E / Hatch, Joseph E / Davis, Stephanie D / Peterson-Carmichael, Stacey

Pediatric pulmonology

2020 Volume 56, Issue 5, Page(s) 1165–1172

Abstract: Introduction: The lung clearance index (LCI) derived from the multiple breath washout test (MBW), is both feasible and sensitive to early lung disease detection in young children with cystic fibrosis and asthma. The utility of LCI has not been studied ... ...

Abstract	Introduction: The lung clearance index (LCI) derived from the multiple breath washout test (MBW), is both feasible and sensitive to early lung disease detection in young children with cystic fibrosis and asthma. The utility of LCI has not been studied in children with sickle cell disease (SCD). We hypothesized that children with SCD, with or without asthma or airway hyperreactivity (AHR), would have an elevated LCI compared to healthy controls. Methods: Children with SCD from a single center between the ages of 6 and 18 years were studied at baseline health and completed MBW, spirometry, plethysmography and blood was drawn for serum markers. Results were compared to healthy controls of similar race, age, and gender. Results: Healthy controls (n = 35) had a significantly higher daytime oxygen saturation level, weight and body mass index but not height compared to participants with SCD (n = 34). Total lung capacity (TLC) z-scores were significantly higher in the healthy controls compared to those with SCD (0.87 [1.13] vs. 0.02 [1.27]; p = .005) while differences in forced expiratory volume in 1 s z-scores approached significance (0.26 [0.97] vs. -0.22 [1.09]; p = .055). There was no significant difference in LCI between the healthy controls compared to participants with SCD (7.29 [0.72] vs. 7.40 [0.69]; p = .514). Conclusion: LCI did not differentiate SCD from healthy controls in children between the ages of 6 and 18 years at baseline health. TLC may be an important pulmonary function measure to follow longitudinally in the pediatric SCD population.
MeSH term(s)	Adolescent ; Anemia, Sickle Cell ; Breath Tests ; Child ; Forced Expiratory Volume ; Humans ; Lung ; Respiratory Function Tests
Language	English
Publishing date	2020-12-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.25186
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Article: Correlation between the clinical severity of laryngomalacia and endoscopic findings.

Alshumrani, Ranya A / Matt, Bruce H / Daftary, Ameet S / Peterson-Carmichael, Stacey L / Slaven, James E / Cristea, A Ioana

Saudi medical journal

2020 Volume 41, Issue 4, Page(s) 406–412

Abstract: Objective: To correlate the clinical severity of laryngomalacia (LM) with endoscopic findings, swallowing evaluations and polysomnography in a cohort of patients. Method: We conducted a retrospective analysis between 2017-2018 on a cohort of patients ... ...

Abstract	Objective: To correlate the clinical severity of laryngomalacia (LM) with endoscopic findings, swallowing evaluations and polysomnography in a cohort of patients. Method: We conducted a retrospective analysis between 2017-2018 on a cohort of patients diagnosed with upper airway obstruction (UAO), stridor, noisy breathing or laryngomalacia. This study took place at the Pediatric Pulmonology Department, Riley Children's Hospital, Indianapolis, United States of America. Results: There were 157 patients with laryngomalacia included in the study. Patients with severe LM were significantly younger than those with mild LM (p=0.0214) and moderate LM (p=0.0220). Subjects with type I of LM were significantly older than type III (p=0.0051). When associations were tested between polysomnogram (PSG) variables and clinical severity, there were significant associations with age at PSG. The overall apnea-hypopnea index (AHI) in mild (p=0.0103) and moderate (p=0.0242) were significantly lower than the severe group. The rapid eye movement (REM) AHI was significantly lower in moderate cases than severe (p=0.0134). The end-tidal carbon dioxide (EtCO2) peak was significantly lower in mild cases than severe (p=0.0141). The total sleep time (TST) peripheral capillary oxygen saturation (SpO2) 90% occurs in both mild (p=0.0197) and moderate (p=0.0498) were significantly lower than the severe group. Conclusions: The severity of the clinical manifestations of LM did not correlate with the different endoscopic types in our study. The presence of cyanosis was associated with type III LM. Rapid eye movement AHI and EtCO2 in polysomnogram were remained significantly associated with clinical severity.
MeSH term(s)	Airway Obstruction/diagnosis ; Airway Obstruction/pathology ; Cyanosis/etiology ; Endoscopy ; Female ; Humans ; Infant ; Laryngomalacia/diagnosis ; Laryngomalacia/pathology ; Male ; Oximetry ; Polysomnography ; Respiratory Sounds ; Retrospective Studies ; Severity of Illness Index ; Sleep, REM
Language	English
Publishing date	2020-04-12
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	392302-2
ISSN	1658-3175 ; 0379-5284
ISSN (online)	1658-3175
ISSN	0379-5284
DOI	10.15537/smj.2020.4.25014
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Article ; Online: Correlation between the clinical severity of laryngomalacia and endoscopic findings

Ranya A. Alshumrani / Bruce H. Matt / Ameet S. Daftary / Stacey L. Peterson-Carmichael / James E. Slaven / A. Ioana Cristea

Saudi Medical Journal, Vol 41, Iss 4, Pp 406-

2020 Volume 412

Abstract: Objectives: To correlate the clinical severity of laryngomalacia (LM) with endoscopic findings, swallowing evaluations and polysomnography in a cohort of patients . Methods: We conducted a retrospective analysis between 2017-2018 on a cohort of patients ... ...

Abstract	Objectives: To correlate the clinical severity of laryngomalacia (LM) with endoscopic findings, swallowing evaluations and polysomnography in a cohort of patients . Methods: We conducted a retrospective analysis between 2017-2018 on a cohort of patients diagnosed with upper airway obstruction (UAO), stridor, noisy breathing or laryngomalacia. This study took place at the Pediatric Pulmonology Department, Riley Children’s Hospital, Indianapolis, United States of America. Results: There were 157 patients with laryngomalacia included in the study. Patients with severe LM were significantly younger than those with mild LM (p=0.0214) and moderate LM (p=0.0220). Subjects with type I of LM were significantly older than type III (p=0.0051). When associations were tested between polysomnogram (PSG) variables and clinical severity, there were significant associations with age at PSG. The overall apnea-hypopnea index (AHI) in mild (p=0.0103) and moderate (p=0.0242) were significantly lower than the severe group. The rapid eye movement (REM) AHI was significantly lower in moderate cases than severe (p=0.0134). The end-tidal carbon dioxide (EtCO2) peak was significantly lower in mild cases than severe (p=0.0141). The total sleep time (TST) peripheral capillary oxygen saturation (SpO2) 90% occurs in both mild (p=0.0197) and moderate (p=0.0498)) were significantly lower than the severe group. Conclusions: The severity of the clinical manifestations of LM did not correlate with the different endoscopic types in our study. The presence of cyanosis was associated with type III LM. Rapid eye movement AHI and EtCO2 in polysomnogram were remained significantly associated with clinical severity.
Keywords	laryngomalacia ; endoscopy ; swallowing study ; polysomnography ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-04-01T00:00:00Z
Publisher	Ministry of Defence and Aviation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The chronically critically ill patient: pediatric considerations.

Peterson-Carmichael, Stacey L / Cheifetz, Ira M

Respiratory care

2012 Volume 57, Issue 6, Page(s) 993–1002; discussion 1002–3

Abstract: Whether defined as chronically critically ill, long-term mechanical ventilator dependent (or otherwise chronically medically supported), or medically fragile, a population of infants and children with chronic illness clearly exists. Infants and children ... ...

Abstract	Whether defined as chronically critically ill, long-term mechanical ventilator dependent (or otherwise chronically medically supported), or medically fragile, a population of infants and children with chronic illness clearly exists. Infants and children with chronic healthcare needs are at an increased risk for physical, developmental, behavioral, and/or emotional conditions and generally require healthcare services of a type or amount beyond that of a general pediatric or adult population. This review will focus on the specific management and psychosocial needs associated with the healthcare of this subgroup of infants and children with chronic illness. Attention will be paid to defining the population, describing trends over time, reviewing their special needs, and discussing outcomes. Increased focus and an increasing quantity of resources for this subgroup of infants and children are needed, as the number of such pediatric patients continues to grow.
MeSH term(s)	Child ; Chronic Disease ; Comorbidity ; Critical Illness ; Humans ; Infant ; Monitoring, Physiologic ; Muscle Weakness/epidemiology ; Muscle Weakness/therapy ; Palliative Care ; Patient Discharge ; Respiration, Artificial ; Respiratory Insufficiency/epidemiology ; Respiratory Insufficiency/therapy ; Tracheostomy
Keywords	covid19
Language	English
Publishing date	2012-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603252-7
ISSN	0020-1324 ; 0098-9142
ISSN	0020-1324 ; 0098-9142
DOI	10.4187/respcare.01738
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Article ; Online: In children, the microbiota of the nasopharynx and bronchoalveolar lavage fluid are both similar and different.

Kloepfer, Kirsten M / Deschamp, Ashley R / Ross, Sydney E / Peterson-Carmichael, Stacey L / Hemmerich, Christopher M / Rusch, Douglas B / Davis, Stephanie D

Pediatric pulmonology

2018 Volume 53, Issue 4, Page(s) 475–482

Abstract: Rationale: Sputum and bronchoalveolar lavage fluid (BALF) are often obtained to elucidate the lower airway microbiota in adults. Acquiring sputum samples from children is difficult and obtaining samples via bronchoscopy in children proves challenging ... ...

Abstract	Rationale: Sputum and bronchoalveolar lavage fluid (BALF) are often obtained to elucidate the lower airway microbiota in adults. Acquiring sputum samples from children is difficult and obtaining samples via bronchoscopy in children proves challenging due to the need for anesthesia and specialized procedural expertise; therefore nasopharyngeal (NP) swabs are often used as surrogates when investigating the pediatric airway microbiota. In adults, the airway microbiota differs significantly between NP and BALF samples however, minimal data exist in children. Objectives: To compare NP and BALF samples in children undergoing clinically indicated bronchoscopy. Methods: NP and BALF samples were collected during clinically indicated bronchoscopy. Bacterial DNA was extracted from 72 samples (36 NP/BALF pairs); the bacterial V1-V3 region of the 16S rRNA gene was amplified and sequenced on the Illumina Miseq platform. Analysis was performed using mothur software. Results: Compared to NP samples, BALF had increased richness and diversity. Similarity between paired NP and BALF (intra-subject) samples was greater than inter-subject samples (P = 0.0006). NP samples contained more Actinobacteria (2.2% vs 21%; adjusted P = 1.4 × 10 Conclusion: Our results provide evidence that NP samples can be used to distinguish differences between children, but the relative abundance of organisms may differ between the nasopharynx and lower airway in pediatric patients. Studies utilizing NP samples as surrogates for the lower airway should be interpreted with caution.
MeSH term(s)	Adolescent ; Bacteria/classification ; Bacteria/genetics ; Bacteria/isolation & purification ; Bronchoalveolar Lavage Fluid/microbiology ; Bronchoscopy ; Child ; Child, Preschool ; DNA, Bacterial/analysis ; Female ; Humans ; Infant ; Male ; Microbiota/genetics ; Nasopharynx/microbiology ; RNA, Ribosomal, 16S/analysis
Chemical Substances	DNA, Bacterial ; RNA, Ribosomal, 16S
Language	English
Publishing date	2018-02-06
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.23953
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Article ; Online: Extracorporeal membrane oxygenation for refractory air leak in a child presenting with bacterial tracheitis.

Dolgner, Anna / Bain, Jesse / Peterson-Carmichael, Stacey L / Turner, David A / Rehder, Kyle J

Respiratory care

2014 Volume 59, Issue 10, Page(s) e163–5

MeSH term(s)	Extracorporeal Membrane Oxygenation ; Female ; Humans ; Infant ; Mediastinal Emphysema/microbiology ; Mediastinal Emphysema/therapy ; Pneumothorax/microbiology ; Pneumothorax/therapy ; Tracheitis/microbiology ; Tracheitis/therapy
Language	English
Publishing date	2014-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.03129
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Article: A 2-year-old girl with co-inherited cystic fibrosis and sickle cell-β+ thalassemia presenting with recurrent vaso-occlusive events during cystic fibrosis pulmonary exacerbations: a case report.

Sobush, Kurtis T / Thornburg, Courtney D / Voynow, Judith A / Davis, Stephanie D / Peterson-Carmichael, Stacey L

Journal of medical case reports

2013 Volume 7, Page(s) 203

Abstract: Introduction: This is the first published report of a young girl with co-inherited sickle cell-β+ thalassemia and cystic fibrosis. Although a small subset of patients with co-inherited cystic fibrosis and other hemoglobinopathies have been reported, ... ...

Abstract	Introduction: This is the first published report of a young girl with co-inherited sickle cell-β+ thalassemia and cystic fibrosis. Although a small subset of patients with co-inherited cystic fibrosis and other hemoglobinopathies have been reported, this patient developed early hematologic and pulmonary complications that were more severe than the previous cases. To assess pulmonary co-morbidities, we used infant pulmonary function testing through the raised volume rapid thoracoabdominal compression technique as both an established study of early cystic fibrosis and also as a newer study of mechanism for early sickle cell lung disease. This further serves as the first report of the raised volume rapid thoracoabdominal compression technique to determine raised volume forced expiratory flows and fractional lung volumes in a patient with a hemoglobinopathy. Case presentation: A 2-year-old African-American girl with co-inherited cystic fibrosis and sickle cell-β+ thalassemia developed severe hematologic complications (recurrent vaso-occlusive events, hepatic sequestration, and acute chest syndrome) during periods of cystic fibrosis pulmonary exacerbations and weight loss. Because cystic fibrosis and sickle cell-β+ thalassemia both confer distinct patterns of pulmonary disease, infant pulmonary function testing with the raised volume rapid thoracoabdominal compression technique was used to define respiratory pathophysiology and guide treatment options. Infant pulmonary function testing data demonstrated moderate-to-severe lower airways obstruction, moderate air trapping, and no evidence of restrictive lung disease. Conclusions: Infant pulmonary function testing with the raised volume rapid thoracoabdominal compression technique guided therapy in this patient with cystic fibrosis and sickle cell-β+ thalassemia. Although this is an original case report on a unique patient, this case highlights the need to evaluate early respiratory pathophysiology in a broader population of young patients with hemoglobinopathies and screen those at risk for early pulmonary co-morbidities.
Language	English
Publishing date	2013-07-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947
ISSN	1752-1947
DOI	10.1186/1752-1947-7-203
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Article ; Online: Survey of clinical infant lung function testing practices.

Peterson-Carmichael, Stacey L / Rosenfeld, Margaret / Ascher, Simon B / Hornik, Christoph P / Arets, H G M / Davis, Stephanie D / Hall, Graham L

Pediatric pulmonology

2014 Volume 49, Issue 2, Page(s) 126–131

Abstract: Background: Data supporting the clinical use of infant lung function (ILF) tests are limited making the interpretation of clinical ILF measures difficult.: Objectives: To evaluate current ILF testing practices and to survey users regarding the ... ...

Abstract	Background: Data supporting the clinical use of infant lung function (ILF) tests are limited making the interpretation of clinical ILF measures difficult. Objectives: To evaluate current ILF testing practices and to survey users regarding the indications, limitations and perceived clinical benefits of ILF testing. Methods: We created a 26-item survey hosted on the European Respiratory Society (ERS) website between January and May 2010. Notifications were sent to members of the ERS, American Thoracic Society and the Asian Pacific Society of Respirology. Responses were sought from ILF laboratory directors and pediatric respirologists. The survey assessed the clinical indications, patient populations, equipment and reference data used, and perceived limitations of ILF testing. Results: We received 148 responses with 98 respondents having ILF equipment and performing testing in a clinical capacity. Centers in North America were less likely to perform ≥50 studies/year than centers in Europe or other continents (13% vs. 41%). Most respondents used ILF data to either "start a new therapy" (78%) or "help decide about initiation of further diagnostic workup such as bronchoscopy, chest CT or serological testing" (69%). Factors reported as limiting clinical ILF testing were need for sedation, uncertainty regarding clinical impact of study results and time intensive nature of the study. Conclusions: Clinical practices associated with ILF testing vary significantly; centers that perform more studies are more likely to use the results for clinical purposes and decision making. The future of ILF testing is uncertain in the face of the limitations perceived by the survey respondents.
MeSH term(s)	Global Health ; Health Care Surveys ; Humans ; Infant ; Pediatrics/methods ; Practice Patterns, Physicians'/statistics & numerical data ; Respiratory Function Tests/instrumentation ; Respiratory Function Tests/methods ; Respiratory Function Tests/statistics & numerical data ; Respiratory Function Tests/utilization ; Surveys and Questionnaires
Language	English
Publishing date	2014-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.22807
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