Division of pulmonary & Critical care

Division of Pulmonary, Critical Care, Allergy & Sleep Medicine

                                      Division Director: Lynn M. Schnapp, MD             Division Administrator: Derek Sanford
                                           Pulmonary and Critical Care Faculty                 Pulmonary and Critical Care Staff
The Division continues to grow in faculty members and expand its clinical responsibilities as well as continuing with outstanding clinical research. The Division has been listed regularly in the top hospitals by US News and World Report. With a team of nationally-renowned faculty, the Division is able to provide expertise in the diagnosis and management of patients with acute and chronic diseases of the chest, sleep disordered breathing, and allergic diseases. Each year, the Division treats more than ten thousand patients from around the world and attracts two hundred applications for five fellowship positions. The Division works with specialties from all disciplines to perform state-of-the-art, comprehensive care for the most ill individuals from across the State of South Carolina and beyond. Services include the use of advance monitoring and ventilation techniques, as well as ECMO in selected cases. The pulmonary faculty has worked aggressively to develop protocols and improve education to the nursing and respiratory staff to provide consistent world class care. Outpatient services are also provided at these hospitals, as well as outreach clinics in Mount Pleasant and North Charleston. We also evaluate patients with end-stage lung disease for lung transplantation, including those with COPD, interstitial lung disease, pulmonary hypertension, and cystic fibrosis. Our critical care physicians care for chronic, “difficult to wean” ventilator patients.
Drs. Alice Boylan and Antine Stenbit have created a multidisciplinary team to care for non-ICU ventilator patients and have established a multidisciplinary team labeled the “vent huddle.” This team, comprised of pulmonologists, respiratory therapists, speech pathologists, physical therapists, occupational therapists, and nursing staff, rounds together daily to coordinate and optimize care. This multidisciplinary approach has led to a shorter number of days on mechanical ventilation, improving patient safety metrics, and other quality metrics such as patient satisfaction.
Dr. Patrick Flume and Dr. Preston Church (from the Infectious Disease Division) have collaborated to establish a rapidly expanding clinic to treat non-tuberculous mycobacteria patients, as this organism is endemic in the soil in the southeast.
Our state-of-the-art Sleep Center focuses on the comprehensive evaluation and management of a myriad of sleep disorders including obstructive sleep apnea, upper airway resistance syndrome, narcolepsy, insomnia, restless leg syndrome, and other sleep-related problems. A multidisciplinary and comprehensive approach is taken in the evaluation of patients in collaboration with specialists in Otolaryngology (ENT), neurology, and psychiatry. The 8- bed certified Sleep Center is designed to meet the rigorous standards of the American Academy of Sleep Medicine.
The Division is committed to the life-long education and training of physicians and the community through fellowships, publications, symposiums, committees, and community outreach. The three-year combined fellowship in Pulmonary, Critical Care, Allergy and Sleep Medicine focuses on developing clinical expertise, as well as research skills in these venues. Two tracks, a clinical research track and a clinical academic track, allow fellows to meet their professional goals
Drs. J. Terrill Huggins and Nicholas Pastis are outstanding clinicians who work regularly in the intensive care units and participate in the interventional bronchoscopy and pleural disease program. Both clinicians have expertise in endobronchial ultrasound (EBUS), and navigational bronchoscopy that helps diagnose end stage lung cancer and other pulmonary diseases relatively non-invasively. Drs. Huggins and Pastis also provide expertise in the diagnosis and management of pleural disease with the use of ultrasonography and pleural manometry. Indwelling catheters are used in patients with refractory pleural effusions, including those with an unexpandable lung.
Dr. Steven Sahn, received the prestigious Edward Livingston Trudeau Medal at the May American Thoracic Society meeting in Denver, Colorado, the University where Dr. Sahn completed his pulmonary training. While in Denver, he was a member of the faculty for ten years prior to coming to MUSC in 1983 to assume the leadership of the Division. During the ATS meeting in Denver, Dr. Sahn was also inducted into the Colorado Pulmonary Hall of Fame.
The Division educational programs are far-reaching and include teaching of medical students, internal medicine residents, anesthesia residents, and pulmonary and critical care fellows. Since 1983, approximately twenty-five percent of the eighty-one fellows who have trained in the Division’s combined Pulmonary and Critical Care Medicine fellowship have chosen careers in academic medicine. Fellowship training focuses on developing clinical expertise as well as research skills in pulmonary disease and intensive care medicine. Those interested in academic careers obtain a Masters in Clinical Research. Fellows with a particular interest in sleep medicine may structure a program enabling them to sit for Sleep Board certification.
Several faculty members collaborate with the Division of Rheumatology investigating the association between gastroesophageal reflux disease, aspiration, and interstitial lung disease in patients with scleroderma. Faculty are also investigating the role of alveolar macrophage cytokines and chemokines in promoting scleroderma interstitial lung disease and participating in the NIH-sponsored scleroderma lung study. The Pulmonary Hypertension Center provides diagnostic studies and management of these patients in collaboration with the Rheumatology and Cardiology Divisions.



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