Clinic for Allergology, Obstructive Lung Diseases and Respiratory Infections
Our clinic specializes in the diagnosis and treatment of acute and chronic allergic, obstructive, infectious, and rare lung diseases. Annually, we manage over 2,000 patients hospitalized in the clinic’s departments and approximately 1,300 in outpatient facilities, and we conduct over 7,000 initial and follow-up outpatient examinations.
Our work is based on national and international guidelines, with daily multidisciplinary collaboration among teams of physicians and other medical and non-medical staff.
We take particular pride in our close collaboration with patients and assisting the work of the National Association of Patients with Severe Asthma (OTA: https://teskaastma.rs) and the Association for Support and Assistance to Individuals with Cystic Fibrosis of Serbia (CF Srbija: https://cfsrbija.rs).
Our physicians engage in continuous international collaboration with recognized European and global health institutions, through projects and research via the European Registry for Severe Asthma (SHARP: https://europeanlung.org/sharp), European Registry for Cystic Fibrosis (ECFSPR: https://pr.ecfs.eu) and European Registry for Bronchiectasis (EMBARC: https://bronchiectasis.hicservices.dundee.ac.uk). In the territory of the Autonomous Province of Vojvodina, we have been conducting active surveillance of acute respiratory infections and influenza-like illnesses for years, in collaboration with the Institute of Public Health of Vojvodina.
Načelnik odeljenja Prof. Dr. Mirna Đurić
Klinički lekari Dr. sc. med. Dušan Škrbić; Specialist MD Jelena Papović, prim.; Spec. Dr. Med. Branislav Tušek
Specijalizant MD Karla Mutibarić
Glavna sestra odeljenja Nurse/Technician Jelena Trifunović
The department focuses on the diagnosis and treatment of patients with acute lower respiratory tract infections, which include acute bronchitis, acute exacerbation of bronchiectasis, and community-acquired pneumonia. Bronchiectasis, pleural effusions, infiltrative lung changes of unclear origin, rare lung diseases, and cystic fibrosis are also diagnosed and treated.
Diagnostics include:
- radiological and imaging methods (chest radiograph, computed tomography (CT) of the chest, ultrasound examination of the upper abdomen, chest, and pleura, perfusion scintigraphy of the lungs)
- inflammatory markers, biochemical and immunological analyses
- microbiological analyses (bacteriological, virological, mycological, parasitological)
- pulmonary function tests and arterial blood gas analyses
- preparation for invasive procedures (pleural puncture, bronchoscopy, transthoracic needle aspiration (TTNA), video-assisted thoracoscopic surgery (VATS), thoracotomy)
The department participates in the surveillance of acute respiratory infections (ARI) and influenza-like illnesses (ILI) in the territory of the Autonomous Province of Vojvodina, enabling timely recognition of trends and optimization of therapeutic protocols. We are involved in the European Bronchiectasis Registry (The European Bronchiectasis Registry – EMBARC: https://bronchiectasis.hicservices.dundee.ac.uk).
Treatment in the department is conducted in collaboration with centers for radiology, microbiology, virology and immunology, laboratory diagnostics, pathophysiology of respiration, bronchoscopy and pathology, respiratory rehabilitation, as well as the Clinic for Thoracic Surgery, ensuring multidisciplinary care, rapid and accurate diagnostics, and optimal therapeutic approach.
Šef odseka Dr. sc. med. Dušan Škrbić
For more than twenty years, adults with cystic fibrosis (CF) have been treated and monitored in the department. By the decision of the Ministry of Health of the Republic of Serbia on June 12, 2020, the Institute for Lung Diseases of Vojvodina (IPBV) in Sremska Kamenica was designated as the Center for Adult Cystic Fibrosis.
The CF center has numerous tasks and responsibilities.
- diagnosis,
- organizing patient transition,
- maintaining a registry,
- outpatient monitoring (during stable phases of the disease every 3 or 12 months or more frequently if needed),
- hospitalization during exacerbation phases of the disease,
- collaboration with:
- reference international centers for the diagnosis and treatment of CF,
- other healthcare institutions,
- patient associations,
- networks of European and global professional associations and organizations for CF,
- continuous education on CF and optimal treatment methods,
- improving the diagnosis and treatment of patients with CF.
The Day Hospital for CF was established in 2019. Through it, patients undergo basic laboratory, radiological, and microbiological examinations as part of the implementation and monitoring of inhaled antibiotic therapy and CFTR (cystic fibrosis transmembrane conductance regulator) modulator therapy.
Within the Center’s operations, a multidisciplinary approach is ensured. The multidisciplinary team (MDT) consists of: pulmonologist, endocrinologist, gastroenterologist and hepatologist, otorhinolaryngologist, ophthalmologist, cardiologist, physiatrist, psychologist, psychiatrist, nutritionist, radiologist, gynecologist, urologist, thoracic surgeon, microbiologist, medical biochemist, geneticist, nurse, social worker. The MDT is essential as each specialist treats the patient from their perspective, collaborating with one another, thereby ensuring comprehensive treatment and continuous monitoring.
Within the Adult Cystic Fibrosis Center, the transition of cystic fibrosis patients from pediatric facilities is implemented. A Patient Transition Commission from Pediatric to Adult Facility for Cystic Fibrosis (IPBV) has been established in accordance with the recommendations of the European Cystic Fibrosis Society (ECFS). The task of the Commission is comprehensive collaboration in the treatment of cystic fibrosis patients during the transition process from the Institute for Health Care of Children and Youth of Vojvodina (IZZZDiOV) and the Institute for Health Care of Mothers and Children of Serbia
A Cystic Fibrosis Consultative Team for Pediatric and Adult Patients has been established at the Institute for Health Protection of Children and Youth of Vojvodina and IPBV, meeting at least once a month to improve the quality of care, treatment, and protection of patients with CF.
The center is a member of the European Cystic Fibrosis Registry for pediatric and adult patients (European Cystic Fibrosis Society Patient Registry – ECFSPR: https://pr.ecfs.eu).
Active collaboration is established with the Association for Assistance and Support to Persons with Cystic Fibrosis of Serbia (CF Serbia: https://cfsrbija.rs), which includes education, counseling, and support activities, thereby further enhancing the quality of care and understanding of patient needs.
Center Structure
- Cystic Fibrosis Clinic
- Cystic Fibrosis Day Hospital
- The center has a dedicated hospital unit exclusively for patients with CF, in accordance with the organization principles of CF centers of the European Cystic Fibrosis Society (ECFS)
Therapeutic Approach
Standards and principles for the treatment and management of patients with CF are applied, along with the recommendations and guidelines of the European Cystic Fibrosis Society (ECFS) necessary for the quality of care and the success of teamwork.
The therapeutic approach includes
Standards and principles for the treatment and management of patients with CF are applied, along with the recommendations and guidelines of the European Cystic Fibrosis Society (ECFS) necessary for the quality of care and the success of teamwork.
- application of innovative medications and evaluation of treatment efficacy
- application of inhaled antibiotic therapy
- early detection of complications – regular quarterly and annual patient check-ups
- treatment of exacerbations of pulmonary disease
- eradication and treatment of chronic colonization by bacteria (P. aeruginosa, etc.)
- maintenance therapy for pulmonary function
- modern respiratory rehabilitation
- monitoring and treatment of liver disease and disorders of other digestive organs
- management of diabetes associated with CF (cystic fibrosis related diabetes – CFRD) and complications of the endocrine system
- treatment of genitourinary system disorders, counseling regarding fertility
- monitoring of fertility and high-risk pregnancies
- coordination of multidisciplinary team members
- continuous education for patients and families
Načelnik odeljenja Prof. Dr. Sci. Med. Biljana Zvezdin
Klinički lekari Prof. Dr. Violeta Kolarov; Doc. Dr. Maja Bogdan; Prim. mr sci. med. spec. Lidija Vrtunski-More, prim.
Specijalizant MD Lucija Vasović
Glavna sestra odeljenja Nurse/Technician Suzana Tolimir
The department provides comprehensive diagnostics, treatment, and monitoring of patients with chronic obstructive pulmonary disease (COPD) and other obstructive airway disorders. The aim of our procedures is to ensure a reduction in the frequency and intensity of symptoms and exacerbations, improvement of lung function and quality of life, with an individualized therapeutic approach based on modern professional recommendations.
The department manages patients with:
- acute exacerbation of COPD
- respiratory failure
- complications of obstructive lung diseases
- the need for intensive diagnostics and therapy optimization
In hospital conditions, we perform:
- modern bronchodilator and anti-inflammatory therapy
- substitutional oxygen therapy
- respiratory rehabilitation
- assessment and treatment of comorbidities and conditions (cardiovascular diseases, metabolic syndrome, anxiety, depression, osteoporosis, etc.)
- education on the proper use of inhalers, smoking cessation, and all non-pharmacological measures
In selected cases, an assessment of the indication for surgical procedures (lung volume reduction, bullectomy) is performed.
Načelnik odeljenja Prim. mr sci. med. spec. Lidija Vrtunski-More, prim.
The clinic specializes in the diagnosis, treatment, and management of patients with COPD.
In daily practice, the following is conducted:
- assessment of the severity and type (“phenotype”) of COPD
- pulmonary function tests (spirometry, plethysmography, diffusion capacity)
- bronchodilator tests
- laboratory tests (alpha-1 antitrypsin, etc.)
- planning and optimization of long-term therapy
- assessment of the need for rehabilitation and oxygen therapy
- education and verification of inhaler use (commonly referred to as “pump”)
- education on procedures during exacerbations, lifestyle, nutrition, and physical activity
We collaborate with the Rehabilitation Service, cardiologist, nutritionist, psychologist, and other specialties as needed.
Načelnik odeljenja Prim. Dr. Spec. Sanja Hromiš, prim.
Klinički lekari Specialist in Medicine Dragan Veličković; Specialist MD Jelena Crnobrnja; Specialist MD Marija Dugajlić
Specijalizanti MD Sonja Gardić; MD Suzana (Beslać) Mandić
Glavna sestra odeljenja Nurse/Technician Marija (Pavlović) Janković
The department specializes in the treatment of severe exacerbations of chronic obstructive pulmonary disease (COPD) and asthma, obesity hypoventilation syndrome (OHS), and acute gas exchange disorders requiring non-invasive mechanical ventilation (NIV).
In daily clinical practice, we combine advanced diagnostics, modern therapy, and individualized care. Thanks to the close collaboration of pulmonologists, allergists, psychologists, physiatrists, radiologists, and other specialists in the treatment of multimorbidity, rapid diagnostics, adequate therapy, and better disease control are ensured. The department actively involves nurses and physiotherapists, responsible for educating and supporting our patients.
Our goal is to provide adequate treatment and ensure safe healthcare through the application of the most modern therapeutic protocols and a multidisciplinary approach.
Načelnik odeljenja Specialist in Medicine Dragan Veličković
The unit is intended for patients with severe respiratory failure who require continuous non-invasive monitoring and advanced respiratory support.
Treatment Focus:
- NIV as first-line therapy
- high-flow nasal oxygen therapy (HFNC)
- non-invasive hemodynamic monitoring
- monitoring of vital parameters and gas exchange
- prevention of the need for invasive mechanical ventilation
- stabilization of acute exacerbations of COPD, OHS, and asthma
- multidisciplinary assessment of comorbidities
In hospital settings, we conduct:
- initiation and titration of ventilators for NIV
- correction of gas exchange disorders
- bronchodilator and anti-inflammatory therapy
- respiratory rehabilitation
- diagnosis and treatment of comorbidities of obstructive lung diseases (cardiovascular diseases, obesity, sleep disorders, metabolic syndrome)
- patient education on long-term disease management
- home application of non-invasive mechanical ventilation
Patients achieve faster stabilization of symptoms, optimization of NIV in hospital and home settings, reduction of the need for invasive ventilation, better control of chronic lung diseases, and continuity of care (hospital treatment – intensive care – NIV outpatient clinic).
This treatment model is in accordance with the latest recommendations of the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Outpatient Clinic for Non-Invasive Ventilation in Home Settings for Patients with COPD and OHS
The clinic operates within the Department of Intensive Care for Obstructive Patients.
The clinic is intended for patients who are using or need to start NIV in home settings.
The clinic conducts:
- assessment of the need for NIV
- adjustment of ventilator parameters for NIV
- education of patients and families on the proper use of the NIV ventilator
- monitoring of therapy effectiveness and tolerance
- tracking of long-term outcomes and complications
- assessment of comorbidities that may affect the outcome of NIV application
The outpatient clinic closely collaborates with the rehabilitation center, cardiologist, endocrinologist, and pulmonary teams.
Šef odseka Prim. Dr. Spec. Sanja Hromiš, prim.
Sestra odseka Nurse/Technician Sanja Bukarica
The day hospital is intended for patients with severe and poorly controlled asthma and other allergic and immunological respiratory diseases that require more frequent monitoring and the application of modern therapeutic protocols.
In the day hospital, the following are conducted:
- precise diagnosis and phenotyping of asthma
- optimization of therapy, including the application of biological therapy for severe asthma and eosinophilic granulomatosis with polyangiitis (EGPA)
- transition of patients with severe asthma from pediatric facilities
- multidisciplinary management of comorbidities
- monitoring outcomes with standardized instruments
- education of patients and healthcare professionals on breathing techniques, proper application of therapy, and avoidance of triggers
- maintaining a registry of severe asthma and participation in research
The work is conducted through multidisciplinary collaboration with psychologists, rehabilitation specialists, physiotherapists, ENT specialists, gastroenterologists, endocrinologists, and cardiologists, enabling a comprehensive assessment and alignment of therapy with the individual needs of patients.
Within the Day Hospital, a Consultation for Severe and Uncontrolled Asthma has been established, which is a professional body responsible for:
- making decisions regarding the indication of biological therapy,
- monitoring the effects of therapy and any changes to the therapeutic regimen,
- evaluation of complex cases and comorbidities.
The consultative team holds regular meetings, consisting of specialists with experience in the diagnosis and treatment of severe asthma and a trained nurse specialized in working with these patients.
We closely collaborate with the National Association of Patients with Severe Asthma (OTA: https://teskaastma.rs) through education, counseling, and support programs, thereby further enhancing the continuity of care and quality of life for patients.
Monitoring patients with severe asthma is also achieved through collaboration with the European Registry for Severe Asthma (Severe Heterogeneous Asthma Research Collaboration, Patient-centred, ERS CRC – SHARP: https://europeanlung.org/sharp).
Therapeutic Approach
In daily practice, the principles of good clinical practice are observed, with therapy guided by national and international guidelines for the treatment of severe asthma, EGPA, and hypereosinophilic lung diseases. This ensures a high standard of healthcare, monitoring the effects of biological therapies, and rationalizing the use of oral corticosteroids.
Šef odseka Specialist MD Jelena Crnobrnja
The Allergy-Pulmonology Clinic provides specialist examinations, diagnostics, treatment, and monitoring of patients with allergic and respiratory diseases.
In the clinic, we perform:
- specialist examinations
- diagnostics, treatment, and monitoring of asthma
- allergy testing (skin prick test, total and specific IgE)
- lung function (spirometry, plethysmography, bronchodilator tests, direct and indirect bronchoprovocation tests)
- patient counseling and education
- preventive examinations and follow-ups
The clinic conducts asthma control assessments, analysis of exacerbating factors, and planning of long-term therapy in accordance with international guidelines.
| Name and Surname | Position | Note / Professional Qualification |
|---|---|---|
| Vojnović Jelena | Senior Nurse in Other Hospital Departments – Head Nurse of the Clinic | Master of Nursing |
| Savić Duško | Nurse in Other Hospital Departments (Therapist) | |
| Orbović Mirjana | Senior Nurse in Other Hospital Departments (Therapist) | Vocational Nurse |
| Kuburić Jasmina | Nurse in Other Hospital Departments (Therapist) | |
| Kijački Nataša | Senior Nurse in Other Hospital Departments (Therapist) | Bachelor of Health Care Organization |
| Trifunović Jelena – A Section | Senior Nurse in Other Hospital Departments – Head Nurse of the Department | Bachelor of Nursing |
| Živanov Jelena – A Section CF | Nurse in Other Hospital Departments | |
| Palalić Jovana – B Section | Senior Nurse in Other Hospital Departments – Head Nurse of the Department | Vocational Nurse |
| Tolimir Suzana – C Section | Nurse in Other Hospital Departments – Head Nurse of the Department | |
| Janković Marija – D Section | Nurse in Intensive Care Level 2 – Head Nurse of the Department | |
| Bukarica Sanja | Nurse in Other Hospital Departments – Head Nurse DB | |
| Hansman Tamara | Nurse in Other Hospital Departments (Allergy Clinic) | |
| Milanović Dragana | Nurse in Other Hospital Departments (Allergy Clinic) | |
| Pavlović Snežana | Senior Nurse in Other Hospital Departments | Master of Nursing |
| Bereš Renata | Nurse in Other Hospital Departments | |
| Andrić Jovana | Nurse in Other Hospital Departments | |
| Rakita Saša | Nurse in Other Hospital Departments | |
| Trnić Milodrag | Nurse in Other Hospital Departments | |
| Božić Branka | Nurse in Other Hospital Departments | Vocational Nurse |
| Stanojević Milica | Nurse in Other Hospital Departments | |
| Đalinac Vuković Tijana | Nurse in Other Hospital Departments | Bachelor of Nursing |
| Furik Sara | Nurse in Other Hospital Departments | Vocational Nurse |
| Milinković Ivana | Nurse in Other Hospital Departments | |
| Dimić Jelica | Nurse in Other Hospital Departments | |
| Budisavljević Miloš | Nurse in Other Hospital Departments | |
| Piptorošević Zorana | Nurse in Other Hospital Departments | |
| Stojadinov Jovana | Nurse in Other Hospital Departments | |
| Vlaškalin Živojin | Nurse in Other Hospital Departments | |
| Živković Mateja | Nurse in Other Hospital Departments | |
| Stanaćev Radovan | Nurse in Other Hospital Departments | |
| Mladenović Lena | Nurse in Other Hospital Departments | |
| Kuruzović Daliborka | Nurse in Other Hospital Departments | |
| Zec Aleksandra | Nurse in Intensive Care Level 2 | |
| Dabić Stefan | Nurse in Intensive Care Level 2 | |
| Jakovljević Nina | Nurse in Intensive Care Level 2 | |
| Trišić Nikola | Nurse in Intensive Care Level 2 | |
| Radenković Đorđe | Nurse in Intensive Care Level 2 | |
| Anđelković Jelena | Nurse in Intensive Care Level 2 | |
| Obadović Aleksandra | Nurse in Intensive Care Level 2 | |
| Narandžić Milan | Nurse in Intensive Care Level 2 |
