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Physician Connection
A Communication Service for Physicians from CHOC and CHOC at Mission. Please Note: Physician Connection is no longer being printed and is now available electronically. Please visit our blog at http://docs.chocchildrens.org for the latest articles for our physician community. You can also receive our electronic Physician Connection newsletter in your inbox by subscribing to our mailing list: http://www.choc.org/subscribe

NICU Director Expands Regional Focus

In 2003, just 10 years after being one of the first CHOC residents, Vijay Dhar, M.D., became medical director of the CHOC NICU. The unit, which recently expanded to 42 beds, is one of only four in Southern California to be classified as a Regional or Tertiary unit by the California Association of Neonatologists. And if the CHOC NICU seems a lot busier these days, that's because it certainly is.

The CHOC NICU admissions have increased by 43 percent over the past two years and the case mix index is higher, as CHOC is receiving more of the most critically ill children from throughout Southern California.

"With our ECMO, nitric oxide and high-frequency ventilation capabilities, we receive referrals not only from Orange County, but from Los Angeles, Riverside, San Bernardino and San Diego counties," Dr. Dhar says. "We are treating more babies with persistent pulmonary hypertension (PPHN). Our excellent transport team is the only one in the region capable of providing high-frequency ventilation and nitric oxide during transport, and more hospitals in the region are recognizing our qualifications. We also provide air transport for critically ill neonates outside the region."

The unit's growth and expansion may also be attributed to the increasingly sophisticated surgical services provided by the pediatric surgery subspecialty program. Offering the only pediatric neurosurgery program in Orange County, the CHOC NICU is receiving more babies with complex neurosurgical needs, including those with hydrocephalus. CHOC neurosurgeons have inserted shunts on babies younger than 30 days old.

"Within the past two years, our cardiac surgery capabilities have become more sophisticated. CHOC pediatric cardiac surgeons are now performing total corrective surgeries on neonates for almost all congenital cardiac defects," says Dr. Dhar, who also serves on the board of the California Association of Neonatologists. "A baby recently came to us whose urinary bladder was not formed. Our pediatric urologist was able to completely reconstruct one, and it was so gratifying to see the result."

CREATING MORE EDUCATION AND RESEARCH OPPORTUNITIES

Although his days as a resident are long past, Dr. Dhar remains actively involved with the CHOC residency program. He has been voted "teacher of the year" several times by CHOC residents, who spend approximately one month in the NICU during each year of residency.

Additionally, Dr. Dhar is associate director of the Joint UCLA Harbor/CHOC Neonatology Fellowship Program. To date, CHOC has had four NICU fellows, and additional physicians have been recruited for 2005. Dr. Dhar also directs the CHOC Neonatal Education Program and holds weekly educational programs with case presentations for NICU nurses.

As an outreach service to the greater physician community, Dr. Dhar has established quarterly conferences for academic and community neonatologists in Southern California. More than 40 physicians, including neonatologists from UCLA, Harbor, CHLA and UCI attended the March 12, 2003 program on nitric oxide on pre-term infants presented by Michael Schreiber, M.D., associate professor of pediatrics at the University of Chicago. On July 29, Augusto Sola, M.D., division director of neonatal/perinatal medicine at Emory University in Atlanta will present "The Changing Relationship of Oxygen and R.O.P." More than 100 physicians were in attendance last October when CHOC hosted Academic Day for Neonatologists of Southern California (ANSOC).

Dr. Dhar is also pursuing new clinical NICU research opportunities, particularly within infection control. He is currently working on studies into cytokines as markers of infection and on fungal infection prophylaxis. He believes research, as well as providing professional education opportunities, is essential for maintaining clinical excellence in the CHOC NICU.

"Our vision is for CHOC to be recognized as one of the top 10 children's hospitals in the country," he says.

Given Dr. Dhar's track record, it should only be a matter of time.

To contact Vijay Dhar, M.D., please call 714-532-8620.

CHOC CHILDREN'S PUBLICATIONS
PHYSICIAN CONNECTION ENEWSLETTER
KIDS HEALTH MAGAZINE
ANNUAL REPORT
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Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

CHOC Children's - 1201 W La Veta Ave, Orange, CA. Phone: 714-997-3000. .