Steven A. Sahn, MD Professor of Medicine Director of Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine

Welcome to The Medical University of South Carolina’s Division of Pulmonary, Critical Care, Allergy and Sleep Medicine’s website.  The Division is committed to its tripartite mission of providing excellent patient care, being on the cutting edge of research, and promoting superior education and training. 

Excellence in Patient Care
The Division at the Medical University of South Carolina has an excellent reputation in the medical school and excels in patient care, teaching and research. This summer we were once again named in the top hospitals list by US News and World Report.  

With a team of twenty nationally renowned faculty, we are 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.  Faculty members are board certified in internal medicine, pulmonary medicine, critical care medicine, sleep medicine, and allergy.  Each year, the Division treats more than ten thousand patients from around the world and attracts two hundred applications for four fellowship slots.

Specialty areas include:

• Allergy
• Asthma
• COPD (including Alpha-1 antitrypsin deficiency)
• Cystic Fibrosis
• Interstitial Lung Disease (especially IPF and Scleroderma)
• Interventional pulmonary medicine
• Lung Cancer
• Occupational Lung Disease
• Palliative Care
• Pleural Disease
• Pulmonary Hypertension
• Pulmonary Thromboembolism
• Sarcoidosis
• Sleep Medicine
• Tuberculosis 
  

The Division is responsible for the care of patients with acute respiratory failure and other critical illnesses in the Medical Intensive Care Unit at Ashley River Tower as well as the Medical University Hospital, the Ralph H. Johnson VA Medical Center, as well as outreach clinics in Mount Pleasant, Goose Creek, and North Charleston.  In addition to providing care for patients with advanced lung disease, the Division evaluates patients with end-stage lung disease for lung transplantation, including COPD, interstitial lung disease, and cystic fibrosis.  The Division also cares for chronic “difficult to wean” ventilator patients at Medical University Hospital and Ashley River Tower. 

Procedures and special techniques performed by the Division include:

• Cardiopulmonary exercise testing
• Chest tube placement and management
• Diagnostic thoracoscopy and talc poudrage
• Endobrochial laser therapy and stent placement
• Endobronchial ultrasound (EBUS) for staging of lung cancer and diagnosis of sarcoidosis
• Evaluation of sleep disordered breathing
• Fiberoptic bronchoscopy with transbronchial biopsy, transbronchial needle aspiration, and bronchoalveolar lavage
• Insertion of indwelling catheters for management of malignant effusions
• Pleurodesis for malignant and non-malignant effusions
• Pulmonary function testing and arterial blood gas analysis
• Right heart catheterization
• Rigid bronchoscopy
• Laser
• Stent
• Ultrasound guided thoracentesis and pleural biopsy
• Ventilator management

Experience is also provided in specialty clinics that diagnose and manage allergy, asthma, sarcoidosis, pleural disease, lung cancer, pulmonary hypertension, interstitial lung diseases including idiopathic pulmonary fibrosis, cystic fibrosis, sleep disordered breathing, and occupational lung disease.

Our state-of-the-art Sleep Center focuses on the comprehensive evaluation and management of a myriad of sleep disorders including obstructive sleep apnea, snoring, upper airway resistance syndrome, narcolepsy, insomnia, restless leg syndrome, and sleep related problems.  A multidisciplinary and comprehensive approach is taken in the evaluation of patients with specialists from our Division plus Otolaryngology (ENT), Neurology, and Psychiatry.  The 8-bed facility is designed to meet the rigorous standards of the American Academy of Sleep Medicine.

Cutting Edge Research
The Division’s faculty are actively involved in research with a complimentary team of 16 research staff members.  In fiscal year 2009 (ending June 30, 2009), we were awarded over $6,000,000 in grant funding.

Areas of research interest with external funding include:

• The Rare Lung Disease Consortium (NIH Office of Rare Diseases) performing clinical studies in alpha-1 antitrypsin deficiency, lymphangioleiomyomatosis, and alveolar proteinosis.
• The Scleroderma Lung Study (NHLBI) performing a clinical study in scleroderma interstitial lung disease.
• The VENT study evaluating bronchoscopic lung volume reduction for advanced emphysema
• The association between gastroesophageal reflux disease, aspiration, and interstitial lung disease in patients with scleroderma in collaboration with the Division of Rheumatology
• 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 Divisions of Rheumatology and Cardiology

Superior Education and Training
The Division of Pulmonary, Critical Care, Allergy and Sleep Medicine is committed to the lifelong education and training of physicians, patients, and the community through fellowships, publications, symposiums, committees, health fairs and community outreach.

The Division offers a three-year combined fellowship in pulmonary and critical care medicine.  Fellowship training focuses on developing clinical expertise as well as research skills in pulmonary disease, intensive care medicine, sleep medicine, and allergic diseases of the chest.  The fellowship program includes two tracks – clinical research and clinical academic – to allow fellows to meet their professional goals.  At the end of three years of training, the fellow is eligible for the American Board of Internal Medicine certification in pulmonary disease and special competency certification in critical care medicine. Fellows with a particular interest in sleep medicine may structure a program enabling them to sit for Sleep Board certification.

In March 2009, the Division held its 19^th Annual Pulmonary and Critical Care Symposium in Charleston, SC. The annual symposium is designed to provide an update in pulmonary and critical care medicine, allergic lung disease, and sleep medicine for the pulmonologist, critical care physician, internist, and thoracic surgeon.  The three, half-day course emphasizes a practical clinical approach to patients using a pathophysiologic basis for the institution of appropriate therapy.

The Division's 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 seventy-three fellows who 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.