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 analysisAchieved 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
2022
Delivery timing for the opioid–exposed infant
Sanusi A, Gray M, Xue Y, Mohr S, Curtis P, Dismukes J, Gentle S, Szychowski J, Brocato B, Casey B, Harper L, Sinkey R. Delivery timing for the opioid–exposed infant. American Journal Of Obstetrics & Gynecology MFM 2022, 4: 100719. PMID: 35977700, PMCID: PMC10961100, DOI: 10.1016/j.ajogmf.2022.100719.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeOpioid-exposed infantsIncidence of neonatal opioid withdrawal syndromeNeonatal opioid withdrawal syndrome treatmentLate-term periodsEarly term deliveryOpioid-exposed neonatesWithdrawal syndromePrimary composite outcomeOpioid use disorderNeonatal outcomesTerm deliveryMedication-assisted treatmentSyndrome treatmentComposite outcomeRisk of neonatal opioid withdrawal syndromeSeverity of neonatal opioid withdrawal syndromeNeonatal intensive care unit admissionAmerican College of Obstetricians and GynecologistsPositive urine toxicology screenPrimary outcomeSecondary outcomesNeonatal intensive care unitPositive urine drug screenA 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-weekBirthWeeks
2020
Early Skin-to-Skin Care with a Polyethylene Bag for Neonatal Hypothermia: A Randomized Clinical Trial
Travers C, Ramani M, Gentle S, Schuyler A, Brown C, Dills M, Davis C, Mwenechanya M, Chomba E, Aban I, Manasyan A, Ambalavanan N, Carlo W. Early Skin-to-Skin Care with a Polyethylene Bag for Neonatal Hypothermia: A Randomized Clinical Trial. The Journal Of Pediatrics 2020, 231: 55-60.e1. PMID: 33373672, DOI: 10.1016/j.jpeds.2020.12.064.Peer-Reviewed Original ResearchConceptsSkin-to-skin careResource-limited settingsEarly skin-to-skin careSequentially numbered sealed opaque envelopesSevere hypothermiaTertiary referral centerPhase 2 treatmentReferral centerNeonatal hypothermiaMaternal temperatureAdverse eventsAlone groupReduce hypothermiaBag groupInfantsHypothermiaClinical trial objectivesOpaque envelopesBirthSkin careTrial objectivesPhase 2CareHoursGroupAirway 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 AlabamaAspirationPretermResultsInfantsPrematurityAssociation of Antenatal Corticosteroids and Magnesium Sulfate Therapy With Neurodevelopmental Outcome in Extremely Preterm Children.
Gentle S, Carlo W, Tan S, Gargano M, Ambalavanan N, Chawla S, Bell E, Bann C, Hintz S, Heyne R, Tita A, Higgins R. Association of Antenatal Corticosteroids and Magnesium Sulfate Therapy With Neurodevelopmental Outcome in Extremely Preterm Children. Obstetrics And Gynecology 2020, 135: 1377-1386. PMID: 32459430, PMCID: PMC7278037, DOI: 10.1097/aog.0000000000003882.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal Cortex HormonesChild, PreschoolDatabases, FactualFemaleGestational AgeHumansInfantInfant MortalityInfant, Extremely PrematureInfant, NewbornLogistic ModelsMagnesium SulfateMaleNeurodevelopmental DisordersPregnancyPregnancy OutcomePrenatal CarePrenatal Exposure Delayed EffectsProspective StudiesUnited StatesConceptsSevere neurodevelopmental impairmentExposed to antenatal corticosteroidsExposure to antenatal corticosteroidsAntenatal corticosteroidsWeeks of gestationNeurodevelopmental impairmentMagnesium sulfateAssociation of antenatal corticosteroidsEunice Kennedy Shriver National Institute of Child HealthMagnesium sulfate therapyNational Institute of Child HealthInstitute of Child HealthAssociated with lower ratesExposure groupRate of deathPreterm childrenNeurodevelopmental outcomesLogistic regression modelsCorticosteroidsFollow-upPrimary outcomeSecondary outcomesTherapyGestationNetwork hospitalsOxygen 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 initiatives
2018
Environmental or Nasal Cannula Supplemental Oxygen for Preterm Infants: A Randomized Cross-Over Trial
Travers C, Carlo W, Nakhmani A, Bhatia S, Gentle S, Amperayani V, Indic P, Aban I, Ambalavanan N. Environmental or Nasal Cannula Supplemental Oxygen for Preterm Infants: A Randomized Cross-Over Trial. The Journal Of Pediatrics 2018, 200: 98-103. PMID: 29705116, PMCID: PMC6109600, DOI: 10.1016/j.jpeds.2018.03.010.Peer-Reviewed Original ResearchConceptsEpisodes of intermittent hypoxemiaPreterm infantsNasal cannulaIntermittent hypoxemiaSupplemental oxygenRandomized cross-over trialCross-over trialGestational agePostnatal dayBirth weightPretermHypoxemiaDecreased episodesInfantsOxygen saturationCannulaHoursPatient monitoringPatientsBirthWeeksTrials