Chief Update: Division of Pulmonary, Critical Care and Sleep Medicine

Innovations in Pulmonology & Sleep Medicine | Winter 2023

The past three years have ushered in unprecedented disruption to healthcare. Throughout this time, the Division of Pulmonary, Critical Care & Sleep Medicine at University Hospitals Cleveland Medical Center has been at the forefront of the pandemic response and return to a new normal.

Our critical care and pulmonary teams have ensured that some of our most vulnerable patients receive expert, personalized treatment in the intensive care environment. And our multidisciplinary sleep medicine team is employing innovative solutions to address the prevalence and burden of disordered sleep, including pivoting to virtual connectivity to foster continuity of care.

Despite the challenges they have encountered, our physician-scientists and basic science researchers have continued to make new discoveries, while our entire faculty has remained committed to clinical excellence, academic productivity and mentorship of our physician trainees. As we transition into 2023, here are some recent updates. 

The Cherniack Inpatient Service

An innovative inpatient service now underway at University Hospitals Cleveland Medical Center is ensuring specialist care for individuals hospitalized with advanced lung disease. The service is named in honor of Neil S. Cherniack, MD, a leading physician-scientist in the field of respiratory control. Dr. Cherniack spent 18 years of his pioneering career at UH Cleveland Medical Center and Case Western Reserve University School of Medicine, ultimately serving as dean and as vice president from 1990 to 1995.  

“Dr. Cherniack was internationally recognized for his research into the regulation of breathing and was awarded an honorary doctoral degree in 1991 from the Karolinska Nobel Institute in Stockholm, Sweden,” says Frank Jacono, MD, Division Chief of Pulmonary, Critical Care and Sleep Medicine at UH Cleveland Medical Center. “The service that bears his name will ensure hospitalized patients with advanced lung disease receive specialist-directed therapy and will provide an important educational opportunity for our pulmonary fellows and residents.”  

Patients receiving advanced care from the Cherniack Inpatient Service include individuals hospitalized with cystic fibrosis, lung transplantation, end-stage pulmonary vascular disease, pulmonary fibrosis, or chronic obstructive pulmonary disease and patients who have undergone a bronchoscopic lung volume reduction procedure. 

New Lung Transplant Program Medical Director Named

Silpa Kilaru, MD

Silpa Kilaru, MD, has been named medical director of the Lung Transplant Program at UH Cleveland Medical Center. For the past 10 years, Dr. Kilaru has served as a pulmonologist and assistant professor of Pulmonary, Allergy, and Critical Care Medicine at the University of Pittsburgh Medical Center. After earning her medical degree at The Ohio State University, she completed an internship and residency at Georgetown University before staying on to complete a pulmonary and critical care fellowship and serving as chief fellow.  

“Dr. Kilaru is a skilled clinician with expertise in the management of patients with advanced lung disease who may benefit from lung transplantation,” says Dr. Jacono. “She is a dynamic individual and teacher, and we are delighted that she has joined our faculty as medical director for Lung Transplantation. She will continue to advance our state-of-the-art treatment of patients with end-stage lung disease, including COPD, interstitial lung disease, cystic fibrosis and pulmonary hypertension.” 

Faculty Highlights

Sameer Avasarala, MD

Sameer Avasarala,MD

• Member-at-large for the Interventional Procedures Section of The American College of Chest Physicians (CHEST) Thoracic Oncology and Chest Procedures Network. CHEST is the leading professional association in innovative chest medicine.  
• Associate Editor of the American Association for Bronchology and Interventional Pulmonology Podcasts 
• First author of the Rapid On-site Evaluation Practice Variability Appraisal (ROSE PETAL) survey, recently published in Cancer Cytopathology. 
• Site PI for the GRAWITAS Study: Multicenter trial designed to compare chest discomfort between gravity-driven and wall suction-driven therapeutic thoracentesis sponsored by M.D. Anderson Cancer Center. 

Kingman Strohl, MD 

Kingman Strohl, MD

• National PI for the SUPRA trial, an FDA Phase III trial of a novel alternative therapy for obstructive sleep apnea (OSA) 
• Author of Comparison of expiratory pressures generated by four EPAP devices in a laboratory bench setting, published in Sleep Medicine.
• Author of Assessments of alternative-to-PAP therapy for OSA using expiratory resistance therapy, an analysis of characterized changes in weight in participants with OSA or narcolepsy treated with solriamfetol (Sunosi™), published in Sleep Medicine.
• Author of Solriamfetol treatment of excessive daytime sleepiness in participants with narcolepsy or obstructive sleep apnea with a history of depression, a multisite study of secondary analysis of the effects of an alerting medication on patients with and without a history of depression, published in the Journal of Psychiatric Research.

Ken Remy, MD and Rana Hejal, MD

Kenneth Remy, MD

Rana Hejal, MD

• Elected as members-at-large for the Research Steering Committee of the Society for Critical Care Medicine, a leading international organization promoting research, education and the highest-quality care for critically ill patients.

Maroun Matta, MD

Maroun Matta,MD

• Co-authored Year two of virtual interviews: longitudinal changes and diverse perspectives, fellowship interview process, published in BMC Medical Education

Cystic Fibrosis Foundation Reaccreditation

After a thorough evaluation by the Cystic Fibrosis Foundation Center Committee, UH Rainbow Babies & Children’s Hospital was granted full reaccreditation for cystic fibrosis care. One of the first centers accredited by the foundation, UH Rainbow has been providing nationally recognized care for children with cystic fibrosis for over 60 years. 

Airway Emergency Workshop

The Division of Pulmonary, Critical Care & Sleep Medicine at UH Cleveland Medical Center hosted an Airway Emergency Workshop in February, where attendees were able to participate in hands-on sessions to practice emergency cricothyroidotomy and bronchial blocker placement.  

New Trials in Critical Care Medicine

• SPIES (Stratifying Patient Immune Endotypes in Sepsis) is a multicenter clinical study of the functional assay, ELISpot, as a predictor of the clinical trajectory in sepsis and critically ill non-septic patients.
• SeptiCyte RAPID (PAXgene/EDTA Blood Sample Type Comparison Study) is a multicenter study to confirm the use of undiluted EDTA blood for the SeptiCyte RAPID sepsis assay. 
• XNW4107 is a multicenter, phase 3 study to evaluate the safety and efficacy of Intravenous Imipenem/Cilastatin-XNW4107 in comparison with Imipenem/Cilastatin/Relebactam in adults with hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia.
• I-SPY COVID Trial is an adaptive platform trial to reduce mortality and ventilator requirements for critically ill patients.

For more information, contact Dr. Jacono at Frank.Jacono@UHhospitals.org.

Contributing Expert:

Frank Jacono, MD

Frank Jacono, MD
Division Chief, Pulmonary, Critical Care and Sleep Medicine
University Hospitals Cleveland Medical Center
Professor of Medicine
Case Western Reserve University School of Medicine