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1. Adherence to and outcomes of a University-Consortium gastroschisis pathway

Author

Daniel A. DeUgarte, Kara L. Calkins, Yigit Guner, Jae Kim, Karen Kling, Katelin Kramer, Hanmin Lee, Leslie Lusk, Payam Saadai, Cherry Uy, Catherine Rottkamp, Jamie Anderson, Aubrey Blanton, Nina Boe, Erin Brown, Michael Choy, Raymond Dougherty, Diana Farmer, Nancy Field, Laura Galganski, Hedriana Herman, Shinjiro Hirose, Gina James, Elyse Love, John McGahan, Amelia McLennan, Giselle Melendres, Francis Poulain, Amy Powne, Gary Raff, Laila Rhee Morris, David Schrimmer, Simran Sekhohn, Sherzana Sunderji, Veronique Tache, Melissa Vanover, Jay Yeh, M Baraa Allaf, Katie Bacca, Elizabeth Blumenthal, Kari Bruce, Lisa Carroll, Robert Day, Jennifer Duffy, David Gibbs, Afshan Hameed, Tamara Hatfield, Alexandra Iacob, Jennifer Jolley, Mustafa Kabeer, Nafiz Kiciman, Nancy Lee, Carol Major, Joshua Makhoul, Yona Nicolau, Elizabeth Patberg, Christina Penfield, Manuel Porto, Pamela Rumney, Valeria Simon, Lizette Spiers, Melissa Westermann, Peter Yu, Kara Calkins, Judith Chung, Ilina Datkhaeva, Daniel DeUgarte, Uday Devaskar, Jaime Deville, Rachel Gutkin, Carla Janzen, Howard Jen, Daniel Kahn, Suhas Kallapur, Steven Lee, Steven Lerman, Melanie Maykin, Aisling Murphy, Tina Nguyen, Victoria Niklas, Rashmi Rao, Gary Satou, Emily Scibetta, Mark Sklansky, Rebecca Stark, Katie Strobel, Renea Sturm, Khalil Tabsh, Afshar Yalda, Rebecca Adami, Laith Alshawabkeh, Tracy Anton, Jerasimos Ballas, Stephen Bickler, Divya Chhabra, Charlotte Conturie, Erika Fernandez, Aileen Fernando, Neil Finer, Andrew Hull, Diana Johnson, Leah Lamale-Smith, Louise Laurent, Frank Mannino, Dora Melber, Mishella Perez, Andrew Picel, Dolores Pretorius, Sandy Ramos, Diana Sanford, Maryam Tarsa, Vy Tran, Douglas Woelkers, Kathy Zhang-Rutledge, Katie Archbold, Victoria Berger, Paul Brakeman, Melissa Catenacci, Shilpa Chetty, Hillary Copp, Emily Edwards, Vickie Feldstein, Neda Ghaffari, Ruth Goldstein, Juan Gonzalez, Kristen Gosnell, Joanne Gras, Michael Harrison, Whitnee Hogan, Romobia Hutchinson, Roxanna Irani, Priyanka Jha, Roberta Keller, Maureen Kohi, Katherine Kosiv, Katie Kramer, Billie Lianoglou, Jennifer Lucero, Tippi MacKenzie, Anne Mardy, Erin Matsuda, Edward Miller, Anita Moon-Grady, Tara Morgan, Amy Murtha, Mary Norton, Natalie Oman, Benjamin Padilla, Shabnam Peyandi, Andrew Phelps, Liina Poder, Annalisa Post, Larry Rand, Naseem Rangwala, Frederico Rocha, Mark Rollins, Melissa Rosenstein, Janice Scudmore, Rachel Shulman, Dorothy Shum, Teresa Sparks, Jeffrey Sperling, Katherine Swanson, Martha Tesfalul, Stephanie Valderramos, Lan Vu, Amanda Yeaton-Massey, Lisa Arcilla, Stacie Bennett, Erin Corbett, and Howard Rosenfeld

Subjects
medicine.medical_specialty, medicine.medical_treatment, Cohort Studies, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Clinical pathway, 030225 pediatrics, medicine, Humans, Intubation, Gastroschisis, Mechanical ventilation, Wound Closure Techniques, business.industry, Infant, Newborn, General Medicine, Evidence-based medicine, Length of Stay, medicine.disease, Respiration, Artificial, Discontinuation, Treatment Outcome, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Pediatrics, Perinatology and Child Health, Cohort, Emergency medicine, Surgery, Guideline Adherence, business, Historical Cohort
Abstract

Our multi-institutional university consortium implemented a gastroschisis pathway in 2015 to standardize and improve care by promoting avoidance of routine intubation and paralysis during silo placement, expeditious abdominal wall closure, discontinuation of antibiotics/narcotics within 48 h of closure, and early initiation/advancement of feeds.Adherence to the gastroschisis pathway was prospectively monitored. Outcomes for the contemporary cohort (2015-2018) were compared with a historical cohort (2007-2012).Good adherence to the pathway was observed for 70 cases of inborn uncomplicated gastroschisis. The contemporary cohort had significantly lower median mechanical ventilator days (2 versus 5; p 0.01) and antibiotic days (5.5 versus 9; p 0.01) as well as earlier days to initiation of feeds (12 versus 15; p 0.01). However, no differences were observed in length of stay (28 versus 29 days; p = 0.70). A skin closure technique was performed in 66% of the patients, of which 46% were performed at bedside without intubation, the assistance of an operating-room team, or general anesthesia.In this study, adherence to a clinical pathway for gastroschisis across different facilities was feasible and led to reduction in exposure to mechanical ventilation and antibiotics. The adoption of a bedside skin closure technique appears to facilitate compliance with the pathway.Level II/III TYPE OF STUDY: Prospective comparative study with historical cohort.

Published
2020
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2. Growth Failure Prevalence in Neonates with Gastroschisis : A Statewide Cohort Study

Author

Katie M. Strobel, Tahmineh Romero, Katelin Kramer, Erika Fernandez, Catherine Rottkamp, Cherry Uy, Roberta Keller, Laurel Moyer, Francis Poulain, Jae H. Kim, Daniel A. DeUgarte, Kara L. Calkins, Nina Boe, Erin Brown, Diana Farmer, Nancy Field, Herman Hedriana, Shinjiro Hirose, Gina James, Elyse Love, Amelia McLennan, Amy Powne, Laila Rhee Morris, Payam Saadai, Sherzana Sunderji, Veronique Tache, Jay Yeh, M. Baraa Allaf, Katie Bacca, Lisa Carroll, Brian Crosland, Robert Day, Jennifer Duffy, David Gibbs, Afshan Hameed, Tamara Hatfield, Alexandra Iacob, Jennifer Jolley, Mustafa Kabeer, Nafiz Kiciman, Nancy Lee, Carol Major, Joshua Makhoul, Yona Nicolau, Manuel Porto, Rebecca Post, Pamela Rumney, Lizette Spiers, Peter Yu, Irfan Ahmad, Nita Doshi, Yigit Guner, Wyman Lai, Pierangelo Renella, Yalda Afshar, Kara Calkins, Ilina Pluym, Daniel DeUgarte, Uday Devaskar, Jaime Deville, Viviana Fajardo, Meena Garg, Christina Han, Kerry Holliman, Carla Janzen, Howard Jen, Suhas Kallapur, Steven Lee, Steven Lerman, Aisling Murphy, Tina Nguyen, Rashmi Rao, Animesh Sabnis, Gary Satou, Mark Sklansky, Katie Strobel, Renea Sturm, Khalil Tabsh, Thalia Wong, Rebecca Adami, Tracy Anton, Jerasimos Ballas, Stephen Bickler, Andrew Hull, Marni Jacobs, Diana Johnson, Karen Kling, Leah Lamale-Smith, Sarah Lazar, Louise Laurent, Tzu-Ning Liu, Celestine Magallanes, Dora Melber, Mana Parast, Mishella Perez, Dolores Pretorius, Sandy Ramos, Maryam Tarsa, Douglas Woelkers, Kathy Zhang-Rutledge, Ian Fraser Golding, Heather Sun, Katie Archbold, Lisa Arcilla, Stacie Bennet, Paul Brakeman, Melissa Catenacci, Shilpa Chetty, Hillary Copp, Erin Corbett, Valerie Dougherty, Sarah Downum, Vickie Feldstein, Neda Ghaffari, Ruth Goldstein, Juan Gonzalez-Velez, Veronica Gonzalez, Kristen Gosnell, Joanne Gras, Michael Harrison, Whitnee Hogan, Romobia Hutchinson, Roxanna Irani, Priyanka Jha, Erna Josiah-Davis, Hanmin Lee, Billie Lianoglou, Jennifer Lucero, Leslie Lusk, Tippi MacKenzie, Anne Mardy, Erin Matsuda, Anita Moon-Grady, Tara Morgan, Amy Murtha, Mary Norton, Natalie Oman, Benjamin Padilla, Sachi Patel, Shabnam Peyandi, Andrew Phelps, Liina Poder, Annalisa Post, Larry Rand, Diana Robles, Frederico Rocha, Howard Rosenfeld, Melissa Rosenstein, Janice Scudmore, Dorothy Shum, Nasim Sobhani, Teresa Sparks, Katherine Swanson, Martha Tesfalul, Stephanie Valderramos, Lan Vu, and Amanda Yeaton-Massey

Subjects
Male, Pediatrics, medicine.medical_specialty, Standard score, Linear Growth Failure, California, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Prevalence, medicine, Hospital discharge, Humans, 030212 general & internal medicine, Growth Disorders, Retrospective Studies, Gastroschisis, Fetus, business.industry, Body Weight, Infant, Newborn, Gestational age, medicine.disease, Body Height, Multicenter study, Pediatrics, Perinatology and Child Health, Female, business, Cohort study
Abstract

OBJECTIVES: To perform a multicenter study to assess growth failure in hospitalized infants with gastroschisis. STUDY DESIGN: This study included neonates with gastroschisis within sites in the University of California Fetal Consortium (UCFC). The study’s primary outcome was growth failure at hospital discharge, defined as a weight or length z-score decrease > 0.8 from birth. Regression analysis was performed to assess changes in z-scores over time. RESULTS: Among 125 infants with gastroschisis, the median gestational age was 37 weeks (IQR 35–37). Length of stay was 32 days (23–60); 55% developed weight or length growth failure at discharge (28% had weight growth failure, 42% had length growth failure, and 15% had both weight and length growth failure). Weight and length z-scores at 14 d, 30 d, and discharge were less than birth (p

Published
2021
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3. Acute Responses to Diuretic Therapy in Extremely Low Gestational Age Newborns: Results from the Prematurity and Respiratory Outcomes Program Cohort Study

Author

Carol J. Blaisdell, James Troendle, Anne Zajicek, Claire Chougnet, James M. Greenberg, William Hardie, Alan H. Jobe, Karen McDowell, Thomas Ferkol, Mark R. Holland, James Kemp, Philip T. Levy, Phillip Tarr, Gautam K. Singh, Barbara Warner, Aaron Hamvas, Philip L. Ballard, Roberta A. Ballard, Roberta L. Keller, Amir M. Khan, Leslie Lusk, Dennis W. Nielson, Elizabeth E. Rogers, David J. Durand, Jeffrey D. Merrill, Eric C. Eichenwald, Candice Fike, Tina Hartert, Paul Moore, Judy Aschner, Scott Guthrie, Nathalie Maitre, Marshall Summar, Carl D'Angio, Vasanth Kumar, Tom Mariani, Gloria Pryhuber, Anne Marie Reynolds, Kristin Scheible, Timothy Stevens, Clement Ren, Rita M. Ryan, C. Michael Cotten, Kim Fisher, Jack Sharp, Judith A. Voynow, Stephanie Davis, Brenda Poindexter, Jonas Ellenberg, Rui Feng, Melissa Fernando, Howard Panitch, Barbara Schmidt, Pamela Shaw, Scarlett Bellamy, and Lynn M. Taussig

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, medicine.medical_treatment, Birth weight, Gestational Age, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive care, Intensive Care Units, Neonatal, Medicine, Humans, 030212 general & internal medicine, Airway Management, Diuretics, Respiratory Distress Syndrome, Newborn, Respiratory distress, business.industry, Respiration, Postmenstrual Age, Infant, Newborn, Gestational age, United States, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, Diuretic, business, Cohort study
Abstract

OBJECTIVE: To determine if daily respiratory status improved more in extremely low gestational age premature infants after diuretic exposure compared with those not exposed in modern neonatal intensive care units (NICU). STUDY DESIGN: The Prematurity and Respiratory Outcomes Program (PROP) was a multi-center observational cohort study of 835 extremely premature infants, gestational ages 23 0/7–28 6/7 weeks, enrolled in the first week of life from 13 U.S. tertiary NICUs. We analyzed the PROP study daily medication and respiratory support records of infants up to 34 weeks postmenstrual age. We determined whether there was a temporal association between administration of diuretics and an acute change in respiratory status in premature infants in the NICU, using an ordered categorical ranking of respiratory status. RESULTS: Infants in the diuretic exposed group of PROP were of lower mean gestational age and lower mean birth weight (p 1) for each day after the initial day of diuretic exposure. CONCLUSIONS: Our analysis did not support the ability of diuretics to substantially improve the extremely premature infant’s respiratory status. Further study of both safety and efficacy of diuretics in this setting are warranted. TRIAL REGISTRATION: Clinicaltrials.gov NCT01435187

Published
2017

4. Respiratory Medications in Infants <29 Weeks during the First Year Postdischarge: The Prematurity and Respiratory Outcomes Program (PROP) Consortium

Author

Rita M. Ryan, Roberta L. Keller, Brenda B. Poindexter, Carl T. D'Angio, Pamela A. Shaw, Scarlett L. Bellamy, Paul E. Moore, Christopher McPherson, James M. Greenberg, Barbara Alexander, Tari Gratton, Cathy Grigsby, Beth Koch, Kelly Thornton, Pamela Bates, Claudia Cleveland, Julie Hoffmann, Laura Linneman, Jayne Sicard-Su, Gina Simpson, Jeanette M. Asselin, Samantha Balan, Katrina Burson, Cheryl Chapin, Erna Josiah-Davis, Carmen Garcia, Hart Horneman, Rick Hinojosa, Christopher Johnson, Susan Kelley, Karin L. Knowles, M. Layne Lillie, Karen Martin, Sarah Martin, Julie Arldt-McAlister, Georgia E. McDavid, Lori Pacello, Shawna Rodgers, Daniel K. Sperry, Amy B. Beller, Mark O’ Hunt, Theresa J. Rogers, Odessa L. Settles, Steven Steele, Sharon Wadley, Shannon Castiglione, Aimee Horan, Deanna Maffet, Jane O'Donnell, Michael Sacilowski, Tanya Scalise, Elizabeth Werner, Jason Zayac, Heidie Huyck, Valerie Lunger, Kim Bordeaux, Pam Brown, Julia Epping, Lisa Flattery-Walsh, Donna Germuga, Nancy Jenks, Mary Platt, Eileen Popplewell, Sandra Prentice, Kim Ciccio, Charles Clem, Susan Gunn, Lauren Jewett, Maria Blanco, Denise Cifelli, Sara DeMauro, Melissa Fernando, Ann Tierney, Lynn M. Taussig, Carol J. Blaisdell, Claire Chougnet, William Hardie, Alan H. Jobe, Karen McDowell, Thomas Ferkol, Aaron Hamvas, Mark R. Holland, James Kemp, Philip T. Levy, Phillip Tarr, Gautam K. Singh, Barbara Warner, Philip L. Ballard, Roberta A. Ballard, David J. Durand, Eric C. Eichenwald, Amir M. Khan, Leslie Lusk, Jeffrey D. Merrill, Dennis W. Nielson, Elizabeth E. Rogers, Judy Aschner, Candice Fike, Scott Guthrie, Tina Hartert, Nathalie Maitre, Marshall Summar, Vasanth Kumar, Tom Mariani, Gloria Pryhuber, Clement Ren, Anne Marie Reynolds, Kristin Scheible, Timothy Stevens, C. Michael Cotten, Kim Fisher, Jack Sharp, Judith A. Voynow, Stephanie Davis, Jonas Ellenberg, Rui Feng, Howard Panitch, and Barbara Schmidt

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, medicine.drug_class, medicine.medical_treatment, Anti-Inflammatory Agents, Gestational Age, Infant, Premature, Diseases, Article, 03 medical and health sciences, 0302 clinical medicine, Prednisone, Intensive Care Units, Neonatal, Surveys and Questionnaires, 030225 pediatrics, Bronchodilator, Administration, Inhalation, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Respiratory system, Diuretics, Prospective cohort study, Bronchopulmonary Dysplasia, business.industry, Infant, Newborn, Infant, Gestational age, medicine.disease, Patient Discharge, Bronchodilator Agents, Oxygen, Treatment Outcome, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Female, Steroids, Diuretic, business, Infant, Premature, medicine.drug
Abstract

OBJECTIVE: To determine patterns of respiratory medications used in neonatal intensive care unit (NICU) graduates. STUDY DESIGN: The Prematurity Respiratory Outcomes Program enrolled 835 babies

Published
2019
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5. Black Race Is Associated with a Lower Risk of Bronchopulmonary Dysplasia

Author

Rita M. Ryan, Rui Feng, Catalina Bazacliu, Thomas W. Ferkol, Clement L. Ren, Thomas J. Mariani, Brenda B. Poindexter, Fan Wang, Paul E. Moore, Claire Chougnet, James M. Greenberg, William Hardie, Alan H. Jobe, Karen McDowell, Aaron Hamvas, Mark R. Holland, James Kemp, Philip T. Levy, Christopher McPherson, Phillip Tarr, Gautam K. Singh, Barbara Warner, Philip L. Ballard, Roberta A. Ballard, David J. Durand, Eric C. Eichenwald, Amir M. Khan, Leslie Lusk, Jeffrey D. Merrill, Dennis W. Nielson, Elizabeth E. Rogers, Judy Aschner, Candice Fike, Scott Guthrie, Tina Hartert, Nathalie Maitre, Marshall Summar, Carl T. D'Angio, Vasanth Kumar, Gloria Pryhuber, Anne Marie Reynolds, Kristin Scheible, Timothy Stevens, C. Michael Cotten, Kim Fisher, Jack Sharp, Judith A. Voynow, Stephanie Davis, Scarlett A. Bellamy, Jonas Ellenberg, Melissa Fernando, Howard Panitch, Pamela A. Shaw, Barbara Schmidt, Lynn M. Taussig, and Carol J. Blaisdell

Subjects
Pediatrics, medicine.medical_specialty, Gestational Age, Infant, Premature, Diseases, Lower risk, Black race, Risk Assessment, behavioral disciplines and activities, White People, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Intensive Care Units, Neonatal, 030225 pediatrics, mental disorders, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Bronchopulmonary Dysplasia, business.industry, Respiratory disease, Follow up studies, Gestational age, medicine.disease, United States, Large cohort, Black or African American, Hospitalization, Survival Rate, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Morbidity, business, Infant, Premature, Follow-Up Studies
Abstract

To use a large current prospective cohort of infants29 weeks to compare bronchopulmonary dysplasia (BPD) rates in black and white infants.The Prematurity and Respiratory Outcome Program (PROP) enrolled 835 infants born in 2011-2013 at29 weeks of gestation; 728 black or white infants survived to 36 weeks postmenstrual age (PMA). Logistic regression was used to compare BPD outcomes (defined as supplemental oxygen requirement at 36 weeks PMA) between the races, adjusted for gestational age (GA), antenatal steroid use, intubation at birth, and surfactant use at birth.Of 707 black or white infants with available BPD outcomes, BPD was lower in black infants (38% vs 45%), even though they were of significantly lower GA. At every GA, BPD was more common in white infants. The aOR for BPD was 0.60 (95% CI, 0.42-0.85; P = .004) for black infants compared with white infants after adjusting for GA. Despite the lower rate of BPD, black infants had a higher rate of first-year post-prematurity respiratory disease (black, 79%; white, 63%).In this large cohort of recently born preterm infants at29 weeks GA, compared with white infants, black infants had a lower risk of BPD but an increased risk of persistent respiratory morbidity.

Published
2019
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6. Dynamic mapping of human cortical development during childhood through early adulthood

Author

Liv S. Clasen, Arthur W. Toga, Jay N. Giedd, Kiralee M. Hayashi, Nitin Gogtay, Tom F. Nugent, Paul M. Thompson, Deanna Greenstein, A. Catherine Vaituzis, Judith L. Rapoport, Leslie Lusk, and David H. Herman

Subjects
Adult, Male, Aging, Dynamic mapping, Time Factors, Adolescent, Biology, Somatosensory system, Early adulthood, Brain mri, medicine, Humans, Cortical surface, Child, Cerebral Cortex, Multidisciplinary, medicine.diagnostic_test, Magnetic resonance imaging, Biological Sciences, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Cerebral cortex, Health, Child, Preschool, Autism, Female, Neuroscience
Abstract

We report the dynamic anatomical sequence of human cortical gray matter development between the age of 4–21 years using quantitative four-dimensional maps and time-lapse sequences. Thirteen healthy children for whom anatomic brain MRI scans were obtained every 2 years, for 8–10 years, were studied. By using models of the cortical surface and sulcal landmarks and a statistical model for gray matter density, human cortical development could be visualized across the age range in a spatiotemporally detailed time-lapse sequence. The resulting time-lapse “movies” reveal that ( i ) higher-order association cortices mature only after lower-order somatosensory and visual cortices, the functions of which they integrate, are developed, and ( ii ) phylogenetically older brain areas mature earlier than newer ones. Direct comparison with normal cortical development may help understanding of some neurodevelopmental disorders such as childhood-onset schizophrenia or autism.

Published
2004

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