2024
Improving Time to Goals of Care Discussions in Invasively Ventilated Preterm Infants.
Gentle S, Cohen C, Carlo W, Winter L, Hallman M. Improving Time to Goals of Care Discussions in Invasively Ventilated Preterm Infants. Pediatrics 2024, 154 PMID: 39359206, PMCID: PMC11524032, DOI: 10.1542/peds.2024-066585.Peer-Reviewed Original ResearchConceptsPostmenstrual ageBronchopulmonary dysplasiaPreterm infantsTracheostomy placementWeeks' PMA.Identifying preterm infantsWeeks postmenstrual ageBPD infantsTracheostomy dependenceInvasive ventilationGoC discussionsVentilatory requirementsTracheostomyVentilator liberationInfantsHospital dischargeMultidisciplinary conferenceQuality improvement initiativesWeeksChart analysisUniversity of AlabamaSMART aimStatistical process control chartsProcess control chartsControl chart analysisTeleneonatal or routine resuscitation in extremely preterm infants: a randomized simulation trial
Gentle S, Trulove S, Rockwell N, Rutledge C, Gaither S, Norwood C, Wallace E, Carlo W, Tofil N. Teleneonatal or routine resuscitation in extremely preterm infants: a randomized simulation trial. Pediatric Research 2024, 1-7. PMID: 39341942, DOI: 10.1038/s41390-024-03545-1.Peer-Reviewed Original ResearchNeonatal resuscitationBag-mask ventilationQuality of resuscitationRoutine resuscitationNo-flow fractionResuscitation groupDelivery outcomesChest compressionsAdverse delivery outcomesQuality of neonatal resuscitationHigh-risk deliveriesAssociated with survivalHospital settingQuality of chest compressionsTime to intubationPreterm infantsNewborn resuscitationSingle-centerEpinephrine administrationLow failure rateResultsFifty-onePrimary outcomeSecondary outcomesResuscitationSimulated resuscitationAchieved oxygen saturations and risk for bronchopulmonary dysplasia with pulmonary hypertension in preterm infants
Gentle S, Singh A, Travers C, Nakhmani A, Carlo W, Ambalavanan N. Achieved oxygen saturations and risk for bronchopulmonary dysplasia with pulmonary hypertension in preterm infants. Archives Of Disease In Childhood 2024, 109: 941-947. PMID: 38937062, PMCID: PMC11503043, DOI: 10.1136/archdischild-2024-327014.Peer-Reviewed Original ResearchConceptsBronchopulmonary dysplasia-associated pulmonary hypertensionOxygen saturation indexSurvival statusPreterm infantsPulmonary hypertensionHigher FiOLt;29 weeks' gestationFraction of inspired oxygenWeeks postmenstrual ageSingle-centre studyNon-invasive predictorCase-control studyPostmenstrual ageWeeks gestationBronchopulmonary dysplasiaRespiratory supportNon-survivorsInfantsOxygen saturationPatient outcomesPretermSurvivalHypertensionWeeksPredictors
2023
Interdependence in the Cardiorespiratory Network of Preterm Infants with Pulmonary Hypertension Using Mutual Information Analysis
Ramanand P, Indic P, Gentle S, Ambalavanan N. Interdependence in the Cardiorespiratory Network of Preterm Infants with Pulmonary Hypertension Using Mutual Information Analysis. 2016 Computing In Cardiology Conference (CinC) 2023, 50: 1-4. DOI: 10.22489/cinc.2023.354.Peer-Reviewed Original ResearchBronchopulmonary dysplasiaPreterm infantsPulmonary hypertensionCardiorespiratory networkComplications of PHHeart ratePH groupMechanisms of disease progressionRespiratory rateDisease progressionPretermInfantsOxygen saturationCardiorespiratory morbidityHypertensionGroupMean delayDysplasiaComplicationsMorbidityInformation based similarity analysis of oxygen saturation recordings to detect Pulmonary hypertension in preterm infants
Ramanand P, Indic P, Gentle S, Ambalavanan N. Information based similarity analysis of oxygen saturation recordings to detect Pulmonary hypertension in preterm infants. Biomedical Signal Processing And Control 2023, 86: 105358. PMID: 37692106, PMCID: PMC10487283, DOI: 10.1016/j.bspc.2023.105358.Peer-Reviewed Original ResearchBronchopulmonary dysplasiaPulmonary hypertensionPreterm infantsClinical course of infantsDetect pulmonary hypertensionCourse of infantsPrevalence of PHManagement of PHOxygen saturation recordingsAssociated with multiple morbiditiesRisk of mortalityOxygen saturation dataAmerican Heart AssociationPH diagnosisClinical courseRespiratory deteriorationConsensus guidelinesInfant groupLung diseaseHeart AssociationComplex cardiovascular conditionsRisk factorsOxygen saturationInfantsFive-minute segmentsHeterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial
Gentle S, Rysavy M, Li L, Laughon M, Patel R, Jensen E, Hintz S, Ambalavanan N, Carlo W, Watterberg K, Laptook A, Keszler M, Vohr B, Hensman A, Vieira E, St. Pierre L, Burke R, Alksinis B, Caskey M, Hoffman L, Johnson K, Keszler M, Knoll A, Leach T, Little E, McGowan E, Stephens B, Watson V, Hibbs A, Walsh M, Wilson-Costello D, Newman N, Bhola M, Payne A, Siner B, Yalcinkaya G, Truog W, Kilbride H, Gauldin C, Pallotto E, Holmes A, Johnson K, Scott A, Poindexter B, Schibler K, Merhar S, Yolton K, Grisby C, Beiersdorfer T, Cahill T, Dudley J, Gratton T, Kirker K, Thompson J, Wuertz S, Polin R, Cotton M, Goldberg R, Malcolm W, Goldstein R, Finkle J, Ashley P, Fisher K, Gustafson K, Mago-Shah D, Warren M, Bose C, Bernhardt J, Bose G, Wereszczak J, Warner D, Clark C, Kicklighter S, Bentley A, Edwards L, Rhodes-Ryan G, White D, Carlton D, Stoll B, Hale E, Loggins Y, Bottcher D, Carter S, Kendrick-Allywood S, Mulligan LaRossa M, Mackie C, Smikle G, Comerford L, Laursen J, Sanders A, Maitre N, Adams-Chapman I, Bremer A, Wilson Archer S, Higgins R, Tyson J, Khan A, Kennedy K, Mosquera R, Duncan A, McDavid G, Alaniz N, Allain E, Arldt-McAlister J, Sana Boral D, Burson K, Dempsey A, Eason E, Evans P, Garcia C, Green C, Hall D, Jiminez M, John J, Jones P, Lillie M, Martin K, Martin S, Mason C, McKee S, Poe M, Rennie K, Rodgers S, Siddiki S, Sperry D, Stephens E, Pierce Tate P, Wright S, Sanchez P, Nelin L, Jadcherla S, Slaughter J, Luzader P, Burkhardt S, Carey H, Chao M, Clark E, Fearns E, Fortney C, Fowler A, Grothause J, Gutentag J, Hague C, McCool J, Nelin M, Park C, Pietruszewski L, Purnell J, Shadd J, Small K, Stein M, Sullivan M, Sullivan R, Timan C, Yeates K, Yoseff-Salameh L, Keim S, Newton J, Levengood K, Batterson N, Rice C, Moallem M, Harmon H, Das A, Wallace D, Banna C, Gantz M, O'Donnell Auman J, Crawford M, Gabrio J, Leblond D, Newman J, Petrie Huitema C, vonLehmden A, Zaterka-Baxter K, Li L, Van Meurs K, Stevenson D, Chock V, Ball M, Bentley B, Chitkara R, Davis A, DeAnda M, DeBattista A, Earhart B, Huffman L, Krueger C, Lucash R, Proud M, Hitchner Reichert E, Sivakumar D, Taylor H, Weiss H, Peralta-Carcelen M, Collins M, Cosby S, Biasini F, Domnanovich K, McNair T, Phillips V, Whitley S, York Chapman S, Devaskar U, Chanlaw T, Geller R, Garg M, Purdy I, Bell E, Colaizy T, Widness J, Brumbaugh J, Johnson K, Walker J, Goeke C, Schmelzel M, Eastman D, Baack M, Meyer L, Hogden L, Henning M, Elenkiwich C, Broadbent M, Van Muyden S, Ellsbury D, Campbell D, Tud T, Fuller J, Beauman S, Backstrom Lacy C, Ruffner Hanson M, Hartenberger C, Kuan E, Lowe S, Sokol G, Papile L, Harmon H, Hines A, Lytle C, Herron D, Gunn S, Smiley L, Dawn Wilson L, DeMauro S, Schmidt B, Eichenwald E, Kirpalani H, Abbasi S, Mancini T, Chaudhary A, Cucinotta D, Bernbaum J, Freeman Duncan A, Dysart K, Gerdes M, Hurt H, Snyder J, Ziolkowski K, D'Angio C, Guillet R, Myers G, Binion K, Chess P, Fallone C, Farooq O, Kent A, Maffett D, Merzbach J, Orme C, Sacilowski M, Sabaratnam P, Scorsone A, Wadkins H, Wynn K, Yost K, Reynolds A, Lakshminrusimha S, Chandrasekharan P, Guilford S, Hartley-McAndrews M, Williams A, Zorn W, Li E, Donato J, McKee K, Coleman K, Bean S, Coleman C, Horihan C, Wyckoff M, Brion L, Heyne R, Vasil D, Adams S, Chen L, De Leon M, Eubanks F, Guzman A, Heyne E, Lee L, Madden L, McDougald E, Pavageau L, Sepulveda P, Twell Boatman C, Tolentino-Plata K, Vera A, Waterbury J, Yoder B, Ohls R, Baserga M, Winter S, Minton S, Sheffield M, Rau C, Baker S, Burnett J, Christensen S, Cole Bledsoe L, Cunningham S, Davis B, Elmont J, Hall B, Loertscher M, Marchant T, Maxon E, McGrath K, Mickelsen H, Morshedzadeh G, Parry D, Reich B, Schaefer S, Stout K, Stuart A, Weaver-Lewis K, Woodbury K, Shankaran S, Chawla S, Natarajan G, Sood B, Bara R, Agarwal P, Bajaj M, Childs K, February M, Goldston L, Johnson M, Panaitescu B, Hinz Woldt E, Barks J, Carlson M, Christensen M, White D, Wiggins S. Heterogeneity of Treatment Effects of Hydrocortisone by Risk of Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants in the National Institute of Child Health and Human Development Neonatal Research Network Trial. JAMA Network Open 2023, 6: e2315315. PMID: 37256621, PMCID: PMC10233424, DOI: 10.1001/jamanetworkopen.2023.15315.Peer-Reviewed Original ResearchConceptsSevere neurodevelopmental impairmentExtremely preterm infantsEffect of hydrocortisoneBronchopulmonary dysplasiaNeurodevelopmental impairmentNational Institute of Child HealthInstitute of Child HealthRandomized clinical trialsBaseline riskPreterm infantsGestational ageFollow-upQuartile 4Reduced rates of bronchopulmonary dysplasiaHuman Development Neonatal Research NetworkQuartile 1Clinical trialsMonths of corrected ageRate of bronchopulmonary dysplasiaRate of neurodevelopmental impairmentRisk of bronchopulmonary dysplasiaRelative riskDay of hydrocortisoneNeonatal Research NetworkTreatment groupsPatent Ductus Arteriosus and Development of Bronchopulmonary Dysplasia-associated Pulmonary Hypertension.
Gentle S, Travers C, Clark M, Carlo W, Ambalavanan N. Patent Ductus Arteriosus and Development of Bronchopulmonary Dysplasia-associated Pulmonary Hypertension. American Journal Of Respiratory And Critical Care Medicine 2023, 207: 921-928. PMID: 36378949, PMCID: PMC10111998, DOI: 10.1164/rccm.202203-0570oc.Peer-Reviewed Original ResearchConceptsBPD-associated pulmonary hypertensionPatent ductus arteriosusDuctus arteriosus patencyPreterm infantsBronchopulmonary dysplasiaPostnatal dayDuctus arteriosusPulmonary hypertensionRespiratory supportModerate to large patent ductus arteriosusBronchopulmonary dysplasia-associated pulmonary hypertensionPreterm infants of gestational ageInfants of gestational ageRetrospective case-control studyEvolving bronchopulmonary dysplasiaExtremely preterm infantsCase-control studyModifiable risk factorsGestational ageDuctal patencyComposite outcomeControl subjectsRisk factorsInfantsPatencyIntermittent Hypoxemia and Bronchopulmonary Dysplasia with Pulmonary Hypertension in Preterm Infants.
Gentle S, Travers C, Nakhmani A, Indic P, Carlo W, Ambalavanan N. Intermittent Hypoxemia and Bronchopulmonary Dysplasia with Pulmonary Hypertension in Preterm Infants. American Journal Of Respiratory And Critical Care Medicine 2023, 207: 899-907. PMID: 36449386, PMCID: PMC10111996, DOI: 10.1164/rccm.202203-0580oc.Peer-Reviewed Original ResearchConceptsBronchopulmonary dysplasia-associated pulmonary hypertensionIntermittent hypoxemiaHypoxemic eventsReceiver operating characteristicPreterm infantsPulmonary hypertensionControl subjectsWeeks 6 daysExtremely preterm infantsWeeks 0 daysHigher risk of deathIdentification of infantsCase-control studyRisk of deathBronchopulmonary dysplasiaDesaturation frequencyEchocardiographic dataPostnatal dayBedside biomarkersIH eventsHigh riskInfantsHypoxemiaHypertensionLong duration433 Achieved oxygen saturations and risk for bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants
Gentle S, Singh A, Travers C, Nakhmani A, Carlo W, Ambalavanan N. 433 Achieved oxygen saturations and risk for bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. The American Journal Of The Medical Sciences 2023, 365: s231-s232. DOI: 10.1016/s0002-9629(23)00440-8.Peer-Reviewed Original Research467 Early fluid status and prediction of severe intraventricular hemorrhage or death in extremely preterm infants
Weaver L, Gentle S, Shukla V, Nakhmani A, Rahman F, Ambalavanan N, Askenazi D, Travers C. 467 Early fluid status and prediction of severe intraventricular hemorrhage or death in extremely preterm infants. The American Journal Of The Medical Sciences 2023, 365: s252. DOI: 10.1016/s0002-9629(23)00474-3.Peer-Reviewed Original Research
2022
Improving Time to Independent Oral Feeding to Expedite Hospital Discharge in Preterm Infants.
Gentle S, Meads C, Ganus S, Barnette E, Munkus K, Carlo W, Salas A. Improving Time to Independent Oral Feeding to Expedite Hospital Discharge in Preterm Infants. Pediatrics 2022, 149 PMID: 35229126, DOI: 10.1542/peds.2021-052023.Peer-Reviewed Original ResearchConceptsIndependent oral feedingOral feeding initiationWeeks PMAPreterm infantsOral feedingFeeding initiationWeeks gestationAchievement of independent oral feedingMedian gestational ageCue-based feedingPlan-Do-Study-Act cyclesExpediting hospital dischargeGestational agePlan-Do-Study-ActBirth weightPretermInfantsHospital dischargeOutcome measuresFeeding assessmentWeeksPMAGestationMultidisciplinary teamAgeA Quality Improvement Bundle to Improve Outcomes in Extremely Preterm Infants in the First Week.
Travers C, Gentle S, Freeman A, Nichols K, Shukla V, Purvis D, Dolma K, Winter L, Ambalavanan N, Carlo W, Lal C. A Quality Improvement Bundle to Improve Outcomes in Extremely Preterm Infants in the First Week. Pediatrics 2022, 149 PMID: 35088085, PMCID: PMC9677934, DOI: 10.1542/peds.2020-037341.Peer-Reviewed Original ResearchConceptsSevere intracranial hemorrhageExtremely preterm infantsPreterm infantsIntracranial hemorrhageRates of acute kidney injuryMedian birth weightSpontaneous intestinal perforationDelayed cord clampingAcute kidney injuryQuality improvement initiativesBaseline rateGestational ageWeeks gestationCord clampingIndomethacin prophylaxisCongenital anomaliesIntestinal perforationBirth weightKidney injuryPrimary outcomeQuality improvement bundleInfantsFirst-weekBirthWeeksDuration of noninvasive respiratory support and risk for bronchopulmonary dysplasia or death
Gentle S, Carper B, Laughon M, Jensen E, Williams A, Travers C, Ambalavanan N, Lal C, Carlo W. Duration of noninvasive respiratory support and risk for bronchopulmonary dysplasia or death. Journal Of Perinatology 2022, 42: 454-460. PMID: 35034096, PMCID: PMC9007818, DOI: 10.1038/s41372-021-01269-2.Peer-Reviewed Original ResearchConceptsNoninvasive respiratory supportDuration of noninvasive respiratory supportBronchopulmonary dysplasiaRespiratory supportAssociated with bronchopulmonary dysplasiaDevelopment of bronchopulmonary dysplasiaRetrospective study of infantsStudy of infantsPreterm infantsWeeks gestationPropensity score matchingNoninvasive supportMedian durationRetrospective studyPotential confoundersIllness severityScore matchingInfantsPropensity scoreGestationDysplasiaDeathDurationAssociationPreterm
2021
MicroRNA 219-5p inhibits alveolarization by reducing platelet derived growth factor receptor-alpha
Freeman A, Qiao L, Olave N, Rezonzew G, Gentle S, Halloran B, Pryhuber G, Gaggar A, Tipple T, Ambalavanan N, Lal C. MicroRNA 219-5p inhibits alveolarization by reducing platelet derived growth factor receptor-alpha. Respiratory Research 2021, 22: 57. PMID: 33596914, PMCID: PMC7891005, DOI: 10.1186/s12931-021-01654-7.Peer-Reviewed Original ResearchConceptsPlatelet-derived growth factor receptor alphaGrowth factor receptor alphaBronchopulmonary dysplasiaPDGFR-AReceptor alphaDevelopment of bronchopulmonary dysplasiaPathogenesis of bronchopulmonary dysplasiaModel of bronchopulmonary dysplasiaExtremely preterm neonatesInhibited alveolar developmentMiR-219Lungs of infantsPulmonary epithelial cellsProspective cohort studyBPD mouse modelGenome-wide analysis studiesHuman infant lungsExposure to hyperoxiaRegulation of alveolarizationIn situ hybridizationPreterm infantsPreterm neonatesTerm infantsNormoxia controlLevel of miR-219
2020
Bronchopulmonary dysplasia is associated with reduced oral nitrate reductase activity in extremely preterm infants
Gentle S, Ahmed K, Yi N, Morrow C, Ambalavanan N, Lal C, Patel R. Bronchopulmonary dysplasia is associated with reduced oral nitrate reductase activity in extremely preterm infants. Redox Biology 2020, 38: 101782. PMID: 33166868, PMCID: PMC7658701, DOI: 10.1016/j.redox.2020.101782.Peer-Reviewed Original ResearchConceptsWeeks post menstrual agePost menstrual ageBronchopulmonary dysplasiaPreterm infantsOral microbiomeBronchopulmonary dysplasia statusMorbidities of prematurityNO bioavailabilityBronchopulmonary dysplasia developmentNitric oxideAssociated with morbidityMenstrual ageNR activitySevere morbidityOral microbiotaPretermInfantsTherapeutic targetNitrate reductase activityPrematurityDysplasiaWeeksBioavailabilityNitrate reductaseDiseaseAirway nitrite is increased in extremely preterm infants with bronchopulmonary dysplasia
Gentle S, Freeman A, Patel R, Ambalavanan N, Lal C. Airway nitrite is increased in extremely preterm infants with bronchopulmonary dysplasia. Respiratory Research 2020, 21: 244. PMID: 32957939, PMCID: PMC7504869, DOI: 10.1186/s12931-020-01508-8.Peer-Reviewed Original ResearchConceptsTracheal aspiratesPreterm infantsNitrite levelsLow birth infantsComplications of prematurityAirways of infantsProspective cohort studyPremature infantsVentilated infantsBirth infantsIncreased nitrite levelsPredictive biomarkersPostnatal dayLung diseaseCohort studyInfantsAirwayConclusionsIn conclusionGestationElevated nitrite levelsUniversity of AlabamaAspirationPretermResultsInfantsPrematurityPredicting BPD: Lessons Learned From the Airway Microbiome of Preterm Infants
Gentle S, Lal C. Predicting BPD: Lessons Learned From the Airway Microbiome of Preterm Infants. Frontiers In Pediatrics 2020, 7: 564. PMID: 32117822, PMCID: PMC7011099, DOI: 10.3389/fped.2019.00564.Peer-Reviewed Original ResearchBronchopulmonary dysplasiaPreterm infantsAirway microbiomeChronic lung disease of prematurityLung disease of prematurityDiagnosis of bronchopulmonary dysplasiaPrediction of bronchopulmonary dysplasiaMicrobiome-mediated therapeuticsDisease of prematurityBronchopulmonary dysplasia developmentChronic lung diseaseAirways of newbornsHost immune systemTime of birthSystems biology approachBPD developmentClinical phenotypeMultifactorial etiologyAirwayImmune systemBacterial diversityInfantsMicrobiome signaturesBiology approachLow biomassOxygen saturation histograms predict nasal continuous positive airway pressure-weaning success in preterm infants
Gentle S, Ambalavanan N, Carlo W. Oxygen saturation histograms predict nasal continuous positive airway pressure-weaning success in preterm infants. Pediatric Research 2020, 88: 637-641. PMID: 31972856, PMCID: PMC7223394, DOI: 10.1038/s41390-020-0772-2.Peer-Reviewed Original ResearchConceptsPreterm infantsCPAP discontinuationOxygen saturationHigher oxygen saturationBackgroundContinuous positive airway pressureConclusionsIn preterm infantsPositive airway pressureCase-control studyWeeks gestationGestational ageAirway pressureControl infantsCPAP exposureBaseline characteristicsCPAPPostnatal weekClinical variablesPretermInfantsInclusion criteriaConsecutive daysGestationFiO2DaysWeaning
2019
Oxygen saturation histogram monitoring to reduce death or retinopathy of prematurity: a quality improvement initiative
Gentle S, El-Ferzli G, Winter L, Salas A, Philips III J. Oxygen saturation histogram monitoring to reduce death or retinopathy of prematurity: a quality improvement initiative. Journal Of Perinatology 2019, 40: 163-169. PMID: 31506527, DOI: 10.1038/s41372-019-0486-7.Peer-Reviewed Original ResearchConceptsSevere retinopathy of prematurityRetinopathy of prematuritySevere retinopathyWeeks gestationReduce deathsRate of deathPreterm infantsConclusionIn infantsPrematurityGestationOxygen saturationHospital dischargeInfantsOutcome measuresQuality improvement initiativesDeathChart auditWeeksCare providersPeriodic assessmentRetinopathyIncreasing timeImprovement initiativesOxygen Therapy and Pulmonary Hypertension in Preterm Infants
Gentle S, Abman S, Ambalavanan N. Oxygen Therapy and Pulmonary Hypertension in Preterm Infants. Clinics In Perinatology 2019, 46: 611-619. PMID: 31345551, DOI: 10.1016/j.clp.2019.05.009.Peer-Reviewed Original ResearchConceptsOxygen saturation targetsPulmonary hypertensionPreterm infantsSaturation targetsOxygen therapyHigher oxygen saturation targetsDevelopment of pulmonary hypertensionOptimal oxygen saturation targetsGoal of oxygen therapyEvaluating infantsCo-morbiditiesPretermHypertensionInfantsTherapyTrialsOutcomesNeOProMPrematurityHypoxemiaHyperoxemia