2023 Department of Pediatrics Academic Annual Report

Dr. Travers received a K23 career development grant from NHLBI to measure lung mechanics, response to treatments and predict longer-term pulmonary outcomes of preterm infants using non-invasive oscillometry. In addition, he received internal research funding from the Kaul Pediatric Research Institute to predict bradycardia episodes in preterm infants with apnea of prematurity using machine learning. He also received funding as a co-investigator from the AHA Health Equity Research Network targeting disparities in maternal-infant health outcomes. NEONATAL BIG DATA AND OUTCOMES RESEARCH Vivek Shukla, M.D., received funding from the Kaul Pediatric Research Institute to study brain MRI radiomics-based prediction of neurodevelopmental outcomes in neonates. In addition, he is awaiting notice of a career development award from the Department of Defense to study machine learning-based early identification of individuals with autism spectrum disorders (ELEVATE project). He also received funding as a co-investigator from the American Heart Association (AHA) Health Equity Research Network targeting disparities in maternal-infant health outcomes. Dr. Shukla is leading the BRAIN/NeuroNICU quality-improvement program, which aims to determine the impact of a neuroprotection interventions bundle on the incidence of severe brain injury or early death in very preterm infants. This QI project showed that the neuroprotection interventions bundle was associated with a significant decrease in severe brain injury or early death in very preterm infants and was recently published in the Journal of Perinatology. NEONATAL QI PROGRAM Sam Gentle, M.D., continued to expand the departmental Pediatric Office for Improvement Science to realize improvement in patient outcomes for children across the state of Alabama using fundamentals of quality-improvement science. He is the co-director along with Dr. Adolfo Molina. Dr. Gentle received a Kaul Pediatric Research Institute Quality and Safety Grant aimed at reducing the proportion of extremely preterm infants born at the UAB that develop bronchopulmonary dysplasia. Dr. Gentle’s quality improvement work is assessing whether early oral feeding initiation is associated with a lower postmenstrual age (PMA) at independent oral feeding and discharge. As a result of his team’s work, PMA at discharge decreased from 38.8 to 37.7 weeks during the first plan-do-study-act cycle, which coincided with an increase in the number of infants initiated on oral feeds at <33 weeks’ PMA from 47% to 80%. The age at independent oral feeding decreased from 37.4 to 36.5 weeks’ PMA. In preterm infants born between 25–32 weeks’ gestation, earlier oral feeding initiation was associated with a decreased PMA at independent oral feeding and discharge. Allison Black, M.D., has been a member of the project planning committee and chair of the clinical practice recommendations subcommittee for the next CIQI (Collaborative Initiatives for Quality Improvement) Project through the Children’s Hospital Neonatal Consortium, Project HOME: Home on Milk Every Time. There are 46 participating centers throughout North America, and the project rollout was October 2022. She will continue to be involved as a member of the project steering committee, site leader, and QI mentor for other centers over the course of the two-year initiative. She also worked with two others in the division to create a palliative care educational curriculum for the neonatology fellowship program. Dr. Black continues to serve as president of the Medical Staff at Children’s of Alabama, Physicians Advisory Council for EPIC at Children’s of Alabama and A TRAsiner for the division when preparing for EPIC. Christine Stoops, D.O., has led the Baby NINJA QI program, which began at Children’s of Alabama in 2015, into to a multicenter collaborative. The simple goal to screen for acute kidney injury (AKI) in infants exposed to nephrotoxic medication (NTM) in the NICU has been impactful. While the program at Alabama continues to show improved and sustainable reductions in all process measures in our NICU, data from the collaborative has also shown reductions in NTM exposure and NTM-induced acute kidney injury (manuscript pending journal submission). Through an NIH-funded pilot and feasibility grant, Children’s of Alabama led a two center prospective study with Cincinnati Children’s Hospital Medical Center (CCHMC) to evaluable the validity of the urinary NGAL (urinary biomarker for AKI) as an alternative, non-invasive screening tool compared to traditional serum creatinine (SCr) [manuscript submitted], which Dr. Stoops presented as a poster presentation at the recent International Symposium on AKI in Children held in Cincinnati, Ohio, and as an oral presentation at the Children’s Hospitals Neonatal Consortium held in Indianapolis, Indiana. The Baby NINJA group at Children’s of Alabama also performed a follow-up study to evaluate the risk of chronic kidney disease (CKD) among Baby NINJA graduates that showed that 52% of NICU graduates exposed to NTM had at least one marker of CKD at median age of five years (manuscript under editorial review). The group’s paper “Implementation Strategies for Baby NINJA (Nephrotoxic Injury Negated by Just-in-time Action) to Prevent Neonatal Medication-induced Kidney Injury” was recently accepted to The Journal of Pediatric Pharmacology and Therapeutics. 2023 PUBLICATIONS HIGH-IMPACT PUBLICATIONS Am J Respir Crit Care Med. 2023 Apr 1;207(7):921-928. Patent Ductus Arteriosus and Development of Bronchopulmonary Dysplasia with Pulmonary Hypertension. Samuel J Gentle, Colm P Travers, Matthew Clark, Waldemar A Carlo, Namasivayam Ambalavanan. Am J Respir Crit Care Med. 2023 May 23. Cardiorespiratory Monitoring Data to Predict Respiratory Outcomes in Extremely Preterm Infants. Namasivayam Ambalavanan, Debra E Weese-Mayer, Anna Maria Hibbs, Nelson Claure, John L Carroll, J Randall Moorman, Eduardo Bancalari, Aaron Hamvas, Richard J Martin, Juliann M Di Fiore, Premananda Indic, James S Kemp, Alaleh Dormishian, Katy N Krahn, Jiaxing Qiu, Phyllis A Dennery, Sarah J Ratcliffe, James F Troendle, Douglas E Lake; Prematurity-Related Ventilatory Control (Pre-Vent) Investigators. JAMA Netw Open. 2023 Oct 2;6(10):e2337690. Health Insurance and Differences in Infant Mortality Rates in the US. Desalyn L Johnson, Waldemar A Carlo, A K M Fazlur Rahman, Rachel Tindal, Sarah G Trulove, Mykaela J Watt, Colm P Travers.

2023 Academic Annual Report

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