Lawrence M Rhein
Director, Center for Healthy Infant Lung Development
Assistant Professor of Pediatrics, Harvard Medical School
I am board-certified in Pediatrics, Neonatology, and Pediatric Pulmonology. neonatologist by training. I completed my residency at the Boston Combined Residency in Pediatrics in 1999, and was Chief Resident at Boston Children’s Hospital in 2000. I completed dual fellowships in the Harvard Neonatal-Perinatal Medicine Fellowship Program and Pediatric Pulmonology at Children’s Hospital Boston (CHB) in 2004.
My early research work was in the laboratory. My first project investigated the role of airway proteinase inhibitors, and earned the Society for Pediatric Research Fellow’s Basic Science Research Award. My next project in the laboratory, describing the role of Fc receptors in Pseudomonal infection, won an award from the 2007 Respiratory Disease Young Investigator’s Forum and has since been published. I spent several years investigating murine models of infection, specifically respiratory syncytial virus.
In 2010, I transitioned out of the laboratory to do more clinical and translational research studies. I expect to complete my Masters in Public Health in 2015.
I have first-authored or senior-authored original publications in the Pediatrics, JAMA-Pediatrics, and Pediatric Pulmonology, and I have written several co-author papers/reviews/chapters. I have given several plenary talks and presented posters in national conferences including Society for Pediatric Research, and the American Thoracic Society.
I have received funding from the Faculty Career Development Award, CHB (2012-14), and the PPQI (2013-2016) to pursue my research on oxygen desaturation patterns and oxygen weaning strategies of infants. I am a member of the Society for Pediatric Research, the American Thoracic Society, and the American Academy of Pediatrics. I am a member of the core team of neonatologists at CHB. I attend for 1-2 months/year as neonatologist and 3 nights and 1 weekend a month at CHB. I also direct the Center for Healthy Infant Lung Development, a clinic dedicated to the care of neonates and infants with lung disease. I train and supervise neonatal fellows and nurse practitioners in decision-making, neonatal procedures, and parental communications. I currently spend 75% of my effort dedicated to research, 20% to clinical, 5% to administrative and teaching.
The goals of my research are to understand the optimal oxygen status of fragile infants with lung disease, balancing the risks of potentially unnecessary exposure to oxygen with the risks of untreated hypoxia. I am using clinical and translational studies to help answer these questions. I utilize long-term recorded oximetry to correlate with biomarkers, and with later outcomes to identify which desaturations might require intervention and which can be safely ignored. In addition to my work on interpretation of oxygen saturation patterns, I have developed a research portfolio studying the care of children with bronchopulmonary dysplasia and follow-up of newborns with other lung diseases. I published results of my clinic database describing under-recognized prevalence of pulmonary hypertension in premature infants, a paper which has changed screening patterns. Recognizing the lack of information available to patients who fail their car-seat challenge, I founded a clinical program to assist these families. I developed a survey to analyze patterns of care by primary care pediatricians for these patients; a manuscript based on these findings has been published, and a second manuscript describing predictors of failure of the car seat challenge, based on my clinical experience, has also already been published.
My database includes symptom questionnaires and clinical and demographic data on over 800 premature infants whom we have followed for up to 10 years. This has allowed me to make important observations about other morbidities that require screening, improving the follow-up care for this special population.
As a neonatologist at Children’s Hospital Boston and Beth Israel Deaconess Medical Center, and as a pediatric pulmonologist, I have the pleasure of knowing some babies from their first breath, and then have the privilege of helping them grow into healthy children and adults.
My motivation is to improve the short-term care of infants with lung disease to ensure better long-term outcomes.