Paul Pianosi, MD

Professor, Department of Pediatrics

Paul Pianosi

Contact Info

Office Phone 612-626-2916

Fax 612-624-0696

Mailing Address:
Pediatric Pulmonary & Sleep Medicine
420 Delaware St SE
MMC 742
Minneapolis, MN 55455

MD, University of Toronto, Toronto, ON, CA

Residency in Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, ON, CA

Clinical Fellowship in Pediatric Respirology, McGill University, Montreal, QC, CA

Research Fellowship in Pediatric Respirology, McGill University, Montreal, QC, CA

Pediatric Respiratory Medicine Specialty Certification, Royal College of Pediatrics & Child Health, UK


Dr. Pianosi is Canadian by birth, of Italian origin, and thus hold multiple citizenships. He obtained his MD from the University of Toronto, completed a pediatric residency at the University of Ottawa (Children's Hospital of Eastern Ontario), and pediatric respiratory medicine fellowship at McGill University (Montreal Children's Hospital. 

After his training, he went on to become an Assistant Professor of Pediatrics and Child Health at the University of Manitoba, then Associate Professor with tenure at Dalhousie University in Halifax, Nova Scotia. After practicing in Canada for 15 years, he moved to the Mayo Clinic in Rochester, Minnesota where he practiced for another 12 years, reaching Full Professor level in Pediatric and Adolescent Medicine. 

In April of 2017 he moved to King's College Hospital, where he spent a little more than a year, but eventually opted to return to the University of Minnesota where he believed he would have the best opportunity to pursue research in an existing exercise testing lab for pediatric subjects. 


The principal line of investigation Dr. Pianosi has pursued over the course of his career has been exploration of clinical exercise testing to address specific physiological questions - questions which may invariably arose during his predominantly clinical tenure. His initial foray dealt with sickle cell disease, but not only as a hematologic or pulmonary condition; rather, as a model for oxygen delivery during exercise. For this reason, he has conducted research in various patient populations. Most recently, this has taken him to studying circulation during exercise in adolescents with POTS (postural orthostatic tachycardia syndrome), because it provides a unique model of regulation of blood flow during exercise. At the same time, and again driven by the wealth of patients presenting with external dyspnoea, he developed pictorial scales to measure dyspnoea and perceives exertion in children during exercise. He studied ventilatory strategy during exercise and composed two manuscripts describing expiratory flow limitation during exercise in otherwise healthy children and teens. 


Research Summary/Interests

In recent years, I have turned my attention to studying the clinical problem of dyspnea in children and adolescents. I see many patients with this complaint in clinic, and it turns out that approximately 1/4 patients with POTS report dyspnea as a prominent and sometimes disabling symptom. I have begun collaboration with an expert in cardiovascular pathophysiology in POTS out of New York Medical College. Nevertheless, the overarching theme of my recent work is dyspnea during exercise, to wit I created and validated pictorial, pediatric dyspnea scales. I wish to understand mechanisms of exertional dyspnea in children and adolescents - both those with cardiopulmonary disease and healthy subjects.

Research Methods/Techniques

Non-invasive measurement of cardiac output during exercise (CO2 or acetylene rebreathing, impedance cardiography); Exercise tidal flow-volume loop analysis


Most Cited:

Pianosi P, LeBlanc J, Almudevar A. Peak Oxygen Uptake and Mortality in Children with Cystic Fibrosis. Thorax 2005; 60:50-4.

Related to Current Research:

  1. Pianosi PT. Flow limitation and dysanapsis in children and adolescents with exertional dyspnea. Respiratory physiology & neurobiology. 2018 Jun 1;252:58-63.
  2. Pianosi PT, Huebner M, Zhang Z, Turchetta A, McGrath PJ. Dalhousie Pictorial Scales Measuring Dyspnea and Perceived Exertion during Exercise for Children and Adolescents. Ann Am Thorac Soc. 2015 Feb 19.
  3. Pianosi PT, Huebner M, Zhang Z, McGrath PJ. Dalhousie Dyspnea and Perceived Exertion Scales: Psychophysical properties in children and adolescents. Respir Physiol Neurobiol 2014 Apr 30. DOI: 10.1016/j.resp.2014.04.003

Book Chapters:

Pianosi PT, Driscoll DJ. Exercise testing. In: Allen HD, et al, editors. Moss and Adams' heart disease in infants, children, and adolescents: including the fetus and young adult. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
7th Edition. Volume I; 2008. pp. 81-94.
8th Edition. Volume I; 2013. pp. 118-33.
9th Edition. Volume I; 2016. Pp. 287-302.

View Dr. Pianosi's full research profile



4th King’s Paediatric Respiratory Conference - April 2018
Bush House, King’s College Hospital, London, UK

  • Dysfunctional breathing (1-day course)
  • Respiratory aspects of POTS

3rd King’s Paediatric Respiratory Conference - April 2017
WEC, King’s College Hospital, London, UK

  • Dysfunctional breathing (1-day course)
  • Approach to Paediatric Dyspnea

3rd European Workshop Clinical Pediatric Exercise Testing (EWCPET) - November 2016
Julius Academy, Broederplein 39-43 in Zeist, Netherlands

  • Ventilatory response to exercise
  • Cardiac output during exercise



  • Pediatric Pulmonology

Board Certifications

  • Royal College of Physicians of Canada - Pediatrics
  • Royal College of Physicians of Canada - Pediatric Respiratory Medicine
  • American Board of Pediatrics
  • American Board of Pediatrics - Pediatric Pulmonology

Clinical Interests

Asthma; CF; chronic lung disease of prematurity