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Team approach suggests an increase in survival rates for our smallest patients

Support from Hospital for Consumptives of Maryland (Eudowood Board) fuels collaboration in pediatric pulmonary hypertension treatment
Posted March 6, 2014

New wonders in pediatric pulmonary hypertension treatment

Drs. Coulson and Collaco take a team approach in treating twins, Isabella and Mark Stewart. Drs. Coulson and Collaco take a team approach in treating twins, Isabella and Mark Stewart.

A team approach has suggested an increase in survival rates for some of Johns Hopkins smallest and most fragile patients.  Mark and Isabella Stewart are among them.  Born at 23 weeks gestation and weighing under two pounds each, they were initially given a 5% chance of survival. 

The twins, who are now two years old, were diagnosed with pediatric pulmonary hypertension, the technical term described as “high blood pressure of the blood vessels in the lung” by J. Michael Collaco, MD, MBA, MPH who specializes in pediatric pulmonary medicine.  Once the twins were transferred to the Johns Hopkins Children’s Center, their care was entrusted to a cross-disciplinary working group and a combined clinic approach, funded through philanthropic support like that of the Eudowood Board. This new collaboration of formerly siloed disciplines, along with a detailed database and greater communication between providers, has stemmed from a directive from George Dover, MD, the Given Professor and director of the Children’s Center.

“I think that he perceived there was a disconnect,” according to John Coulson, MD, of Pediatric Cardiology, who explains the condition requires care from several sub-specialties. “The lung tissue of premature infants is not fully developed, and consequently the right‑sided pumping chamber of the heart which pumps the blood to the lungs has to generate more pressure in order to force blood through the lungs,” he explains. “That pumping chamber is susceptible to failure.”

Past studies have gauged the mortality rate of pediatric pulmonary hypertension at 20%. However, since the new approach began three years ago, Collaco says preliminary findings suggest a drop to 12-15% at Johns Hopkins.  Both Collaco and Coulson credit philanthropy for helping fuel these new initiatives.

“It’s just astonishing and fills us with wonder,” says Eudowood Board President Luke Marbury, about the advances in care for this vulnerable patient population. The Eudowood Board has supported Johns Hopkins in areas like pediatric pulmonary medicine for the last 50 years.

“There's no way that we would’ve progressed the way that we have had they not been working closely together,” according to Courtney Stewart, mother of Mark and Isabella, both of whom are cared for by Collaco and Coulson. “I am forever grateful. They saved my kids’ lives.”