Moving Ahead by Questioning Conventional Wisdom

At the Catherine and Henry J. Gaisman Division of Pulmonary, Critical Care and Sleep Medicine, 2022 was a year of questioning the conventional wisdom to move the field forward on multiple fronts.

This report begins with a look at our asthma research, which posits that asthma is actually a collection of diseases along a spectrum of obstructive airways diseases that could be susceptible to a precision medicine approach, once specific subtypes are identified and better understood. Working on this approach alongside veteran researchers such as Linda Rogers, MD, and Sonali Bose, MD, MPH, is Mount Sinai’s new Chair of the Department of Medicine, Monica Kraft, MD. Dr. Kraft was a frequent collaborator of ours while she was at the University of Arizona and we are extremely pleased to have her on board.

Pleuroscopy and exercise physiology are two often-overlooked approaches to diagnosing and treating pulmonary disease, but as this report shows, here at Mount Sinai we are using them successfully in both realms.

Our lung transplant program is off to a strong start, helping patients such as Jehovah’s Witnesses whom other programs might have turned away. Another indication of the team’s expertise in complex procedures is that nearly half of the transplants performed to date have been double-lung transplantations.

In sleep medicine, we are exploring whether even brief interruptions in continuous positive airway pressure treatment for sleep apnea might increase a patient’s risk for dementia. There is concerning evidence of a link between apnea-related hypoxia and sleep fragmentation and biomarkers for Alzheimer’s disease.

An artificial intelligence tool developed by our researchers is showing promise at accurately calculating whether a patient is ready to come off mechanical ventilation—something intensivists have been seeking for a long time. And in the wake of the COVID-19 pandemic, we have taken steps in our ICUs to adjust and prepare for the long haul, and the next time.

As young pulmonologists are trained in our field, teaching skills are often overlooked. We are addressing this with a curriculum that teaches pulmonary fellows how to teach. We think it is important to pass our knowledge on to colleagues in the specialty as well as to the next generation. In that spirit, I hope you enjoy this report.

We were proud to be ranked in the top 20 this year for Pulmonology and Lung Surgery by U.S. News & World Report, and hope you will consider voting for us again. And as always, I welcome your comments at charles.powell@mssm.edu.