Stanford Center for Excellence in Pulmonary Biology

Disorders of the airway, respiratory tract, esophagus, and upper gastrointestinal tract often require complex medical and surgical care.  The pediatric aerodigestive team at Lucile Packard Children’s Hospital Stanford works together to streamline this process by coordinating all aspects of patient care, constantly striving to provide the best outcome for each patient.

Our dedicated team consists of specialists from the departments of otolaryngology, head and neck surgery, pulmonary medicine, gastroenterology, pediatric surgery and speech-language pathology. Together, the aerodigestive team organizes clinic visits, diagnostic tests and operating room procedures among all necessary health care providers to ensure the highest quality of care. This coordination and interdisciplinary communication maximizes patient safety, improves results and minimizes discomfort.

Our team of experts works to correctly diagnose and treat children of all ages with mild, moderate and severe asthma. Asthma can often be misdiagnosed, but our team of pediatric pulmonologists has decades of experience diagnosing and treating asthma and many other lung conditions. Once a child is diagnosed with asthma, we work with the patient and his or her family to manage it from multiple angles.

Bronchopulmonary dysplasia (BPD) was first defined by William Northway and colleagues Stanford University in 1967, and since then, we’ve been at the forefront of efforts to better understand and treat the disease. The mortality rate for premature infants has progressively decreased, coincident with improvements in prenatal, perinatal and neonatal care. However, the incidence of BPD remains high in context of the improved survival of extremely preterm infants, and the resultant changing phenotype of the disease. In addition, there is a growing understanding of the role of pulmonary vasculature disease in BPD, with recent recommendations supporting increased screening for pulmonary hypertension in infants with BPD.

From a clinical standpoint, our multidisciplinary care team helps manage BPD from every angle. Working closely with neonatologists, cardiologists, respiratory therapists, registered dieticians, social workers and care coordinators we ensure seamless transition of care for patients from the Lucile Packard Children’s Hospital Stanford Neonatal Intensive Care Unit (NICU) or other NICUs throughout the Bay Area to our outpatient BPD clinic. For patients who have both BPD and who are at-risk for, or have a known diagnosis of pulmonary hypertension, we have developed the multidisciplinary Cardiac and Respiratory care for Infants with BPD (CRIB) Program. From a research perspective, our Center for Excellence in Pulmonary Biology is conducting cutting-edge research into the biology of BPD and how it develops, with the goal of uncovering new treatment options.

Cystic Fibrosis (CF) is one of the most common genetic (inherited) diseases in America. It is also one of the most serious. It mainly affects the lungs and the digestive systems in the body, causing breathing problems and problems digesting foods. It is a chronic disease that currently has no cure. 

The CF Center at Stanford is an integrated disease management program that follows patients from diagnosis through adulthood. 

With the current longer life expectancy for patients with Cystic Fibrosis, our clinic population includes patients of all ages. More than half the patients followed by the Stanford CF Center are adults aged 18 years or older.

Pediatric “interstitial lung diseases ILDs” represent a heterogeneous group of diseases that generally affect the lung diffusely.  They comprise some of the most challenging pediatric lung conditions to diagnose and treat. We have established a multidisciplinary clinic that brings together experts in  lung transplantation, lung development, and rheumatology to bridge the clinical sciences with our evolving understanding of the basic biology of each of the cell types in the lung.

In order to develop targeted therapies for each disease, we need to understand the diversity of individual cell types within the normal lung and how perturbations during normal development or in response to a variety of injuries (toxins, drugs, infectious agents) give rise to each of the clinical conditions listed below. We are using the most advanced single cell whole genome measurements combined with high-resolution imaging of proteins and RNA to visualize individual cells in situ to understand individual diseases at the level of single cells.

With one of the best post-operative outcomes for adolescents in the world, the lung transplant team at Children’s Hospital Stanford has performed more than 50 pediatric double lung transplants since 1989. Dr. Conrad leads the program, and is faculty member of the Pediatric Pulmonary Center of Excellence. Lung transplantation is a highly specialized and generally rare option for treatment for children with end-stage lung disease.  Lung transplantation offers the promise of treatment for otherwise untreatable lung diseases.

Packard Children’s is one of only 13 hospitals in the United States that participates in the International Pediatric Lung Transplant Collaborative. We partner closely with them, which allows for in-depth analysis and comparison of the efficacy of treatment regimens across centers and generalize findings. A common treatment regimen allows participating centers to collect data together to advance knowledge and inform the practice of immunosuppressive treatment for all patients. Through the IPLTC, universal guidelines for immunosuppression have been developed in pediatric lung transplantation. With this established, future research efforts can identify the effect of treatments that improve survival, such as the most effective medical regimens to treat rejection or infections that can occur after transplant. Database sharing and other studies are in progress, keeping LPCH at the forefront of innovation and research in transplant medicine.

For patients experiencing difficulty breathing or prolonged respiratory illnesses, the cause may be respiratory insufficiency and muscle weakness caused by a neuromuscular disorder like muscular dystrophy or congenital myopathy.

Our multidisciplinary team of experts can help assess, diagnose and manage respiratory complications from these conditions and improve breathing and overall health. Our team takes a proactive approach with a goal to maintain pulmonary health and good quality of life.  We also participate in cutting-edge clinical trials and other important research to help develop new therapies and work toward cures.

The Pediatric Sleep Program brings together pediatric pulmonology and sleep medicine specialists to evaluate and treat children who experience sleepiness or sleeplessness. We treat children from birth through adolescence, and we are the only sleep center in the Bay Area that can evaluate children younger than five years old. We diagnose and treat everything from common conditions like sleep apnea to complex conditions with associated sleep problems, such as neuromuscular diseases, genetic and craniofacial syndromes, and severe heart and lung disease. We also help assess behavioral and developmental disorders that can be associated with sleep problems, such as ADHD. We also conduct EEG tests, which can help diagnose epilepsy. Learn more about making an appointment or referring a patient to the program.