Department of Medicine
University of Pittsburgh
David Kristo, MD
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Visiting Associate Professor of Medicine Phone: 412-692-2880 |
Bio
David Kristo received his M.D. from the Southern Illinois University School of Medicine in 1988. After completing his internship. Medical Residency, and Pulmonary Disease Fellowship at Fitzsimons Army Medical Center in Aurora, Colorado he went on to an Army sponsored Critical Care Medicine Fellowship at the University of Utah in Salt Lake City. Subsequently he served overseas at the U.S. Army Landstuhl Regional Medical Center as Chief Pulmonary Critical Care Medicine and Director of the Combined (Medical-Surgical) Intensive Care Unit with direct support to all Allied casualties in peacekeeping operations in Bosnia. Dr. Kristo also helped start the first Sleep Medicine Center at Landstuhl Regional Medical Center.
In 1997 Dr. Kristo transferred to Walter Reed Army Medical Center where he ran the Sleep Medicine Service and led the military in establishing the first military sleep medicine center credentialed by the American Academy of Sleep Medicine. Subsequently the Walter Reed Sleep Medicine Center also received approval as one of the two initial military medical centers to initiate sleep medicine fellowships. Dr Kristo was named the first Walter Reed Sleep Medicine Fellowship Director.
Ultimately Dr. Kristo was promoted to Colonel Regular Army and served as the Chief of Pulmonary Critical Care Medicine and Sleep at Walter Reed and received his fifth Meritorious Service Medal. Dr. Kristo received an Army Achievement Medal for liaison work in following burn patients for a year after the Pentagon attack, has the Army “A” designator, received the Order of Military Medical Merit and is Airborne qualified, and was an Associate Professor of Medicine at the Uniformed Services University School of Health Sciences (USUHS) at Bethesda, Maryland. During a family illness Dr. Kristo took a final position at the National Naval Medical Center in Bethesda, MD as Director of the Medical-Surgical ICU which remains in the direct medical support line for combat operations in Afghanistan and Iraq.
Dr. Kristo served on the American Academy of Sleep Medicine Clinical Practice Review Committee and ultimately chaired the committee while populating the Sleep Education.com web site with discussions of almost every sleep medicine disorder. Sleep Education.com has generated considerable and growing patient access interest.
More recently, Dr. Kristo worked on the Obstructive Sleep Apnea (OSA) Clinical Guideline Task Force with generation of a clinical guideline paper. The OSA paper is meant to shape and direct how clinicians worldwide provide comprehensive care for obstructive sleep apnea.
Clinical Interests
Dr. Kristo is most interested in providing high quality state-of-the-art medical care in Sleep Medicine for a broad and diverse patient population. This clinical interest manifests in credentialed laboratory operations and record patient accesses of overnight studies for years in succession. Additionally for example daily operational problems such as patients unable to sleep in a sleep laboratory are addressed with studies assessing effects of zolpidem on the quality of the sleep study while streamlining access with a team of providers lending to rapid release of results and meaningful quick clinical action on problems such as sleep apnea affecting patients’ safety and quality of life. Guideline papers and task force involvement lead to this same zeal for high quality care playing out on an international scale through committee work and guideline paper formulation.
Professional links formed through committee work promise additional efforts through teams of like minded physicians intent on providing the best possible diagnostic evaluation and treatment options for patients both locally and internationally.
Academic and Research Interests
Dr. Kristo previously first authored work on the Silent Upper Airways Resistance Syndrome (SUARS) which employed routine use of esophageal manometry, a gold standard but labor intense and seldom used diagnostic technique. The SUARS work stands as one of the most comprehensive assessments of incidence of SUARS within a patient population and helps explain sleepiness in the absence of obvious sleep disorders.
Dr. Kristo also first authored a paper validating the use of telemedicine in electronically transporting sleep study data by Internet thus expanding the access of sleep studies in remote areas with interpretation by trained physicians elsewhere. Internet transfer of sleep studies is now a routine part of daily sleep medicine clinical work within the field.
Dr Kristo also co-authored efforts to assess home monitoring of patients on continuous positive airway pressure (CPAP) which proved that patients could be successfully followed on CPAP from remote locations with a home monitoring system. This finding is even relevant in metropolitan areas for those with transportation problems and difficulty in accessing the medical system in person.
Committee work in defining best patient care approaches in peri-operative care in sleep apneics, use of non-prescription remedies in sleep disorders, obstructive sleep apnea care, and prevalence of concomitant psychiatric disease in sleep clinic patients helps better define the sleep medicine field. Additionally this committee work directs care in areas without fully defined evidence based research to support medical actions required.
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The normal anatomy of the upper airway |
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An airway that is obviously compromised by surrounding tissues and at risk for both upper airway resistance and obstructive sleep apnea. |
The benefits of continuous positive airway pressure (CPAP) in opening a compromised airway. |
Key Publications
Kristo D, Lettieri C, Andrada T, Eliasson A. Silent upper airway resistance syndrome: Incidence in a mixed military population CHEST 2005;127(5):1654-1657.
Kristo D, Andrada T, Eliasson A, Poropatich R, Netzer C, Bradley J, Loube D, Netzer N. Telemedicine in the sleep laboratory: Feasibility and economic advantages of polysomnograms transferred online. Telemedicine Journal and e-Health 2001;7(3) 219-224.
Taylor Y, Eliasson E, Andrada T, Kristo D, Howard R. The role of telemedicine in CPAP compliance for patients with obstructive sleep apnea syndrome Sleep and Breathing 2006 10(3):132-8.
PubMed Link
News
Dr. Kristo has been quoted in website articles by Awake in America and Medical News Today.