About Pulmonary, Critical Care, Hyperbaric and Sleep Medicine
What’s in a name?
The Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine began at the College of Medical Evangelists, now Loma Linda University, in 1914 when Gayle Mosley, MD; Charles C. Browning, MD; Harvey Smith, MD; and L.D. Remington, MD, were recruited as clinical teachers for diseases of the chest. Dr. Remington was the leader of the group, with the rank of Clinical Professor. In 1919, the first official name of the service was Diseases of the Chest, with Carl R. Howson, MD, as the first Head. In 1928, long before the advent of effective anti-tuberculous drugs, the service name was changed to Department of Tuberculosis. Perhaps in a flashback to 1919, the service was again named Diseases of the Chest in 1940.
From the 1950’s to 1970’s a number of luminary physicians headed the service, including Marvin Harris, MD, and George Burton, MD. In 1977, Department of Medicine Chair, John E. Peterson, MD, established ten sections in the Department, one of which was a newly branded Pulmonary Section with John E. Hodgkin, MD, as Head, followed by Richard L. Sheldon, MD. In 1982, Department of Medicine Chair Varner Johns, MD, renamed the service as the Pulmonary and Intensive Care Section.
In 1985, Philip M. Gold, MD, became the Head, serving in that role for 28 years and shaping regional care and a generation of learners. Department of Medicine Chair James J. Couperus, MD, rebranded the Section as an academic Division of Pulmonary and Critical Care Medicine. David Bland, MD, became the Division Head in 2013, and then Executive Vice-Chair, under Department of Medicine Chair Douglas Hegstad, MD.
In 2015, H. Bryant Nguyen, MD, MS, was appointed as the current Division Head. With its expanding services to the hospital and the region, the Division was renamed the Division of Pulmonary, Critical Care, Hyperbaric, and Sleep Medicine.
John E Hodgkin, MD, was the “founding” Program Director for the Pulmonary and Critical Care Fellowship in 1978. The fellowship has continued without interruption since. Philip M. Gold, MD, provided directorship for the program from 1985 to 2016. With the added collaboration between the American Board of Internal Medicine and American Board of Emergency Medicine, the fellowship has provided critical care training for select emergency medicine residency graduates since 2011.
Ramiz Fargo, MD currently serves as the Program Director for the fellowship program that includes clinical and research experiences at Loma Linda University Medical Center, VA Loma Linda Healthcare System, and Riverside University Medical Center (formerly known as Riverside County Regional Medical Center).
Since its inception, the Division has participated in a number of landmark research initiatives that have resulted in major changes in patient care, such as:
- Outcome of COPD patients treated with bronchodilators delivered by metered dose inhaler vs. intermittent positive pressure breathing (IPPB).
- Safety and efficacy of high frequency oscillatory ventilation, leading to FDA approval of a high frequency ventilator.
- Efficacy of anti-TNF alpha and human recombinant activated protein C, leading to FDA approval of drotrecogin alfa (activated) (Xigris) for the management of severe sepsis prior to 2012.
- Outcome effectiveness of the sepsis bundle, leading to CMS approval of the sepsis measures.
- Accuracy of cell-cycle arrest biomarkers, leading to FDA approval of NephroCheck® for the diagnosis of acute kidney injury.
- Longstanding active research programs in the area high altitude medicine, exercise physiology, COPD and pulmonary rehabilitation, mechanical ventilation and weaning, sleep and hyperbaric medicine.
Our division is the regional referral center for complex pulmonary and critical care cases, including interventional pulmonology, pulmonary vascular diseases, thoracic oncology, sleep medicine and hyperbaric medicine.