Outpatient Clinics
BPD Clinic (Pulmonary Clinic)
Faculty: Dr. Rangasamy Ramanathan and Dr. Manuel Durand
The purpose of the Pulmonary Clinic is to care for the newborns with chronic lung disease or bronchopulmonary dysplasia (BPD) who are oxygen-dependent at discharge from the hospital. These patients are discharged from our NICU and from other NICUs in the Greater Los Angeles area; they are followed in our Pulmonary Clinic until they are off oxygen and stable on room air. Patients are typically very low birth weight infants with a birth weight of less than 1250 grams.
The fellow is responsible for attending the Pulmonary Clinic with Dr. Ramanathan or Dr. Durand. The fellow will develop skills / expertise to be able to provide information, education and guidance to parents of infants with BPD; he/she will also become familiar with the services that are available to infants with a variety of disabilities and through which agencies they may be obtained. The Pulmonary Clinic occurs once per month. It may occur more often to accommodate the patients depending on the number of infants with BPD.
Respiratory therapists from the NICU will evaluate the patients on their current level of oxygen and also do challenges either at lower levels of oxygen or on room air to assess if weaning is possible. The neonatologists (Dr. Ramanathan and Dr. Durand) and the neonatology fellows will assess each patient to see if the patients’ oxygen and respiratory medications can be weaned, changed, or discontinued. Follow up will be at the discretion of the neonatologists. Parents are given printed information regarding BPD and medication reconciliation is done during each clinic visit.
Once the patient is on room air, the pediatrician and nurse practitioner will follow these patients or they may receive well child care in the clinics of their parents’ choice. Older patients, or patients with BPD despite optimal treatment will be referred to the pulmonary clinic at Children’s Hospital Los Angeles as needed at the discretion of the neonatologists and medical director.
High Risk Infant Follow-up Clinic
Faculty: Dr. Douglas Vanderbilt
Follow-Up Clinic rotation is part of the fellowship training under the direction of the developmental pediatrician at Los Angeles General Medical Center. In addition, fellows also attend High Risk Infant Follow-up Program at Children’s Hospital Los Angeles under the direction of the developmental pediatrician, Dr. Douglas Vanderbilt to follow patients treated with inhaled nitric oxide and / or ECMO. The fellow is able to perform complete neurobehavioral examinations on the newborn infant and distinguish normal and abnormal findings at varying gestational ages. The fellow gets training with physical examination and evaluation skills of the premature and developmentally suspect NICU graduates, and develops evaluation skills for various ages up to 3 years of life with special emphasis on the first year of life. The fellow is also taught skills to be able to provide information, education and guidance to parents of infants with varying disabilities. The goal is for fellows to become familiar with the services that are available to infants with a variety of disabilities and how or through which agencies the services may be obtained.