Roles of the multidisciplinary team

Cardiology: Performs tilt-table testing, heart rate variability assessment, mapping of cardiac rhythm abnormalities, echocardiograms, 72-hour Holter recordings, and implantation of cardiac pacemakers.

Cardiovascular-thoracic surgery: Implants diaphragm pacers, ideally thoracoscopically.

Endocrinology:  Comprehensively assesses all hormones produced and regulated by the child’s hypothalamus and pituitary.

Ear, nose and throat:  Determines the child’s optimal tracheostomy tube size through bronchoscopy.

Gastroenterology, hepatology and nutrition; general surgery:  Gastroenterology assesses intestinal motility for the Hirschsprung disease patients and those that are non-Hirschsprung but severely constipated, while general surgery performs surgical revision of the intestines as needed.

Genetics, birth defects and metabolism:  Offers genetic counseling for CCHS, ROHHAD, and families affected by sudden infant death syndrome (SIDS).
Ophthalmology:  Does comprehensive testing pertinent to the ANS.

Neurocognitive professionals:  Does annual diagnostic testing to determine progress between hospitalizations and identify areas for targeted intervention.

Neurology:  Interprets MRIs and CTs, as well as EEGs, and helps develop tools to assess pain perception.

Plastic and reconstructive surgery:  Helps with children whose faces have been deformed from prolonged use of mask ventilation since early infancy.

Psychiatry (child and adolescent):  Assesses perception of anxiety as a measure of ANSD and develops a better understanding of the flat affect in ROHHAD patients.

Pulmonary medicine:  Performs pulmonary function testing as well as ventilatory responses to hypoxemia (decreased oxygen) and hypercarbia (elevated carbon dioxide).

Urology: Assesses for problems related to the child’s bladder and delayed bladder emptying.