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Pulmonary and Critical Care (Adult)
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Pulmonary and Critical Care

Pulmonary and Critical Care Medicine services at Yale-New Haven Hospital are nationally and internationally recognized for providing advanced care for patients. Our highly trained and dedicated medical teams offer inpatient and outpatient services to diagnose and treat a wide range of respiratory diseases and disorders.

Pulmonary and Critical Care (Adult)

Why Choose YNHH for Pulmonary and Critical Care

Pulmonary and Critical Care Medicine at Yale-New Haven Hospital is a world-renowned leader in the diagnosis, care and treatment of a variety of diseases and disorders, including asthma, lung cancer, interstitial lung disease, pulmonary fibrosis, cystic fibrosis, COPD, pulmonary vascular disease, tuberculosis and sleep-disordered breathing. As our range of services have expanded over the years, today we are recognized not only for our outstanding patient care but also for cutting-edge research and educational activities.

Our multidisciplinary medical teams are board certified in internal medicine, pulmonary medicine, critical care medicine and sleep medicine; and they work in concert with physicians, nurses and other staff in thoracic surgery, diagnostic and interventional radiology, thoracic oncology and pathology.

New procedure helps asthmatics breathe

pulmonary Doctors at the Yale Center for Asthma and Airways Disease (YCAAD) are offering a new treatment that shows promise for moderate to severe asthma. Bronchial thermoplasty uses radiofrequency energy to gently heat the airways and decrease the tissue in the lungs that is responsible for bronchoconstriction and asthma attacks.



Pulmonary and Critical Care Services

Inpatient Services

We provide inpatient Critical Care Services in our adult intensive care units (ICUs), which offer specialized care, treatment and monitoring of critically ill patients.

The Medical Intensive Care Unit (MICU) — regarded as one of the region's elite ICUs — cares for patients admitted with a wide variety of medical problems. The MICU offers specialized care, treatment and monitoring of critically ill adult patients admitted with a wide range of life-threatening disorders, such as septic shock, acute respiratory distress syndrome, fulminant liver failure and multi-organ failure. The clinical condition of these patients necessitates physician expertise and specialized nursing and technology found at Yale-New Haven's MICU.

The MICU is located in a state-of-the-art facility on two floors of the new North Pavilion, providing 40 MICU beds alongside 16 step-down beds.

At the Neurosurgical ICU (NICU), a team of neurologists, neurosurgeons, medical intensivists and highly trained staff members care for patients who have suffered stroke, traumatic brain and spine injury, subarachnoid hemorrhage, aneurysm, autoimmune and movement disorders (Parkinson's disease, multiple sclerosis, Gullian-Barre, etc.) and neurological disorders. Patients in the unit are closely monitored for subtle neurological changes. The unit actively participates in stroke and brain tumor research. We also offer consultation to medical staff at other intensive care units.

Outpatient Services

Yale-New Haven Hospital's renowned Winchester Chest Clinic provides state-of-the-art evaluation and treatment services to patients with tuberculosis, asthma, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary vascular processes, lung cancer, cystic fibrosis and undiagnosed or general respiratory problems. Patients are seen by pulmonologists who work in close collaboration with specialists in allergy and immunology, otolaryngology, gastroenterology, chest radiologists, thoracic surgeons, diagnostic radiologists, cardiothoracic surgeons and pulmonary pathologists to provide definitive diagnoses and therapeutic options across the spectrum of pulmonary medicine.

The Thoracic Oncology Program (TOP) at Smilow Cancer Hospital at Yale-New Haven provides cutting-edge evaluation and treatment to patients with thoracic malignancies such as lung cancer, esophageal cancer, thymoma or chest wall tumors. The program has become a flagship multidisciplinary program of Yale Cancer Center and Smilow Cancer Hospital. Its clinicians have made and are continuing to make landmark contributions in developmental therapeutics and molecular testing for mutations in the epidermal growth factor receptor gene, helping to usher in the era of personalized targeted therapy for patients with advanced lung cancer.

The program coordinates and integrates the diagnosis, evaluation and treatment of patients in collaboration with cancer physicians who are nationally and internationally recognized for their expertise in these types of cancer. Their specialties include medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, pathology, diagnostic imaging and nursing. Patients cared for by TOP physicians benefit from the team's collective expertise, their close attention to the physical, emotional and psychological issues that are part of effectively confronting cancer, and the involvement of the team's care coordinators, who make treatment plans less complicated. Physicians meet at the multidisciplinary TOP clinic and tumor board to discuss significant diagnostic or treatment issues of each patient.

The Pulmonary Vascular Disease Program (PVDP) addresses the complex needs of patients with pulmonary hypertension. As a regional tertiary care referral center, the PVDP fosters important and timely collaborative interactions with other internationally renowned Yale-New Haven Hospital specialists to provide the most comprehensive pulmonary hypertension care in the Northeast region. This coordination of specialists is possible within the largest academic multispecialty practice in Connecticut and in New England. Patients with pulmonary hypertension also benefit from a single medical record of tests and treatment, and convenient access to compassionate and professional care and education for themselves and their family members.

Patients evaluated in the PVDP have access to information about multiple clinical trials focusing on research that advance our understanding of pulmonary hypertension, at the basic and translational level (including for example the role of endothelial cells, inflammatory cells and cytokines), clinical research, and at the advanced clinical management level. The pulmonary hypertension clinicians are heavily involved in educational activities at the local level in Connecticut and also at the national level, in education and training of patients, their families/care providers, and physicians to help combat pulmonary hypertension.

The PVDP includes physicians specifically trained and experienced to manage patients with pulmonary hypertension, nurses, coordinators, and researchers. The services provided include:

  • Outpatient specialized clinic
  • Designated floors in the hospital for pulmonary hypertension patients
  • State-of-the-art heart catheterization laboratory that is equipped to do elaborate and highly specialized right heart catheterizations (that include vasodilatory challenge tests most commonly using inhaled Nitric Oxide, fluid challenges, and exercise challenges during the right heart catheterization).
  • Highly trained and qualified cardiologists who read echocardiograms focusing on the right side of the heart (which is a key clinical factor in patients with pulmonary hypertension).

Common tests for patients with pulmonary hypertension may include:

  • Blood tests
  • Chest X-ray
  • Pulmonary function tests
  • Sleep study and/or overnight oximetry study
  • Echocardiogram (ultrasound of the heart)
  • Six-minute walk test
  • Heart catheterization
  • Ventilation/Perfusion scan (also called V/Q scan) (looking for blood clots in the lungs)

The Thoracic Interventional Program is a collaborative effort between pulmonary medicine and thoracic surgery to provide the most up-to-date evaluation of lung nodules or masses, mediastinal adenopathy, airway conditions and pleural disease. The team provides an expedited, comprehensive assessment and state- of-the-art treatment through the following services:

  • Flexible bronchoscopy for masses, infiltrates or other appropriate conditions
  • Mediastinal assessment using video-mediastinoscopy or endobronchial ultrasound (EBUS)
  • Rigid bronchoscopy for foreign body removal, stent placement and therapy for tracheobronchial obstruction due to cancer or benign lesions
  • Whole lung lavage and bronchial thermoplasty

Pleural procedures include chest tube placement (pneumothorax, empyema, others); tunneled pleural catheters (Denver drains, Pleurx) for malignant effusions; diagnostic/therapeutic thoracentesis with bedside ultrasound; thoracoscopy for undiagnosed pleural effusions; and pleurodesis. Additional procedures include percutaneous or open tracheostomy, narrow band imaging for premalignant lesions, alveoloscopy/confocal microscopy and endobronchial valve placement.

The Sleep Center evaluates, diagnoses and treats sleep disorders and related conditions. As an accredited member center of the American Academy of Sleep Medicine, this multidisciplinary program offers a coordinated approach to managing sleep-related breathing disorders, such as snoring and sleep apnea, restless legs syndrome, circadian and shift work-related disorders, narcolepsy, insomnia, and parasomnias such as sleep walking and talking. Our physicians are board certified in sleep medicine, internal medicine and pulmonary diseases. As an interdisciplinary program, they work closely with specialists in otolaryngology, neurology, cardiology, psychology, dentistry and bariatric surgery.

The Occupational and Environmental Lung Diseases Program is a collaborative, multidisciplinary effort involving medical specialists from pulmonary and critical care medicine, occupational and environmental medicine, and pathology. Patients with asthma, interstitial lung disease and other pulmonary disorders are evaluated to determine whether environmental and/or occupational exposures may be causing or worsening their lung diseases. Workplace and home environmental assessments may be performed by a member of our industrial hygiene team as part of the evaluation and plan for treatment. This is the only such program in the country where specific inhalation challenge testing is performed for diagnostic and research purposes.


 Among the best in the U.S.

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Yale-New Haven Hospital has been named as one of the top hospitals in the United States, according to U.S.News & World Report's annual "Best Hospitals" rankings.

Yale-New Haven ranked among the very best in the nation in 11 medical specialties, including pulmonology, which ranked #19.


Research

In addition to patient care, the Yale-New Haven Pulmonary and Critical Care Program is home to a rich tapestry of basic, clinical and translational research activities. Research faculty are all successful investigators in their own right, but also cooperate closely with their peers in both basic and clinical departments to pursue interdisciplinary projects.

The Program has a wide and varied research portfolio that extends from basic bench-focused studies of disease pathogenesis and target gene validation to human-based studies of clinical issues such as asthma, COPD, ILD, acute lung injury and pulmonary vascular disease. A unifying theme among the bench-focused investigators is the desire to elucidate the cellular and molecular events involved in lung injury and repair. The result has been an intense focus on immunology and molecular biology and the development of scientific approaches that are now used throughout the world.

Learn more about pulmonary & critical care medicine clinical research initiatives.

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Yale School of Medicine
Magnet Recognition Best Hospitals 2012-2013

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