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Research

Several areas of scholarship are available for fellows in the program.
Recent and ongoing studies are listed below by category:

Basic Sciences Research:

  • Pulmonary and vascular biology, oxidative stress, and pulmonary hypertension:  Phil Shaul, Chieko Mineo
    • Pathogenesis of bronchopulmonary dysplasia/chronic lung disease and novel therapies
    • Molecular basis of vascular disease
    • Molecular mechanisms and novel therapies for pregnancy complications in the Antiphospholipid Syndrome (APS)
    • Hyaluronan (Hyaluronic acid) and its role in inflammation and endothelial function
    • The NLRP3 inflammasome in the pathogenesis of BPD
    • Pulmonary endothelial function, nitric oxide, persistent pulmonary hypertension
    • Oxidative stress and free radical injury
  • Cardiovascular System and metabolic syndrome: Phil Shaul
    • Mechanisms linking obesity with insulin resistance and hypertension
  • Microbiome and necrotizing enterocolitis: Julie Mirpuri-Hathiramani
    • The gut microbiome and its effects on immune mechanisms of inflammatory bowel conditions in the developing gut
    • Maternal high fat diet and its effects on the gut microbiota in offspring

Translational Research:

  • Pulmonary and vascular biology and oxidative stress:  Vishal Kapadia
    • Hyaluronan (Hyaluronic acid) and its receptors in bronchopulmonary dysplasia
    • Oxidative stress and free radical injury, use of oxygen during initial stabilization phase and during hospital stay in neonates
  • Neonatal neurology: Lina Chalak
    • Hypoxic-ischemic encephalopathy: Mechanism of injury; assessment of new recognition tools such as the amplitude EEG; translational research utilizing a piglet model of asphyxia; optimizing neuro-protection offered by hypothermia; rewarming after hypothermia; cerebrovascular hemodynamic modulation of asphyxiated infants; neurodevelopment, near-infrared spectroscopy, Doppler measurement of resistive index
    • Cerebral Neurovascular Autoregulation - Advanced Wavelet methodologies for real-time, non-invasive assessment of neonatal brain injury
  • Microbiome, gastrointestinal tract, necrotizing enterocolitis and growth: Julie Mirpuri-Hathiramani, Eric Ortigoza, Katherine Stumpf
    • Use of non-invasive technologies to obtain physiologic measurements of the gastrointestinal system in premature babies and to study postnatal gastrointestinal development and feeding intolerance in premature newborns.
    • Microbiome in preterm infants versus gastrointestinal motility, anemia and transfusion, antibiotic usage, necrotizing enterocolitis, nutrition and growth
  • Neonatal infection, placenta pathology: Imran Mir, Lina Chalak
    • Fetal-placental crosstalk occurs through fetal cytokine synthesis and placental clearance

Clinical Research, Quality Improvement and other Scholarship:

  • Resuscitation: Myra Wyckoff, Vishal Kapadia, Noorjahan Ali, Venkat Kakkilaya, Shalini Ramachandran, Luc Brion
    • Randomized trials: temperature control, oxygen delivery, resuscitation educational interventions
    • Observational studies: ETCO2 guidance of CPR, effectiveness of epinephrine dosing
    • Studies using the resuscitation database, which includes detailed information about all resuscitation team calls since 2005
    • Delivery room endotracheal intubation, CPAP
    • Titration of oxygen delivery vs. morbidity and mortality
    • Analysis of resuscitation data from national database
    • Retention of NRP skills post NICU rotation
    • Studies using CMC resuscitation database which includes detailed information about all codes in CMC NICU since 01/01/2011
    • Studies using multicenter resuscitation database (from 01/01/2011 until 12/31/2016) which includes all codes at CMC NICU, Seattle Children's Hospital, Children's hospital of Pittsburgh and Children's Hospital of Colorado
  • Neonatal neurology: Lina Chalak, Julide Sisman, Luc Brion
    • Neuro NICU at Parkland: Importance of term-equivalent MRI in very preterm infants
    • Hypoxic-ischemic encephalopathy:assessment of new recognition tools such as the amplitude EEG; optimizing neuro-protection offered by hypothermia; rewarming after hypothermia; cerebrovascular hemodynamic modulation of asphyxiated infants; neuroimaging; neurodevelopment, near-infrared spectroscopy, Doppler measurement of resistive index
    • Prospective research on infants with mild encephalopathy: the PRIME study
    • Intraventricular hemorrhage
    • Lenticulostriate vasculopathy
    • Magnetic resonance imaging at term equivalent
    • Neonatal neurology fellowship (1-year training following either a neonatal-perinatal medicine fellowship or a pediatric neurology fellowship)
    • Post-hemorrhagic hydrocephalus
    • Neonatal nutrition vs. head growth and neurodevelopment
  • Preterm lung disease, bronchopulmonary dysplasia and pulmonary hypertension:  Phil Shaul, Vishal Kapadia, Sushmita Yallapragada, Luc Brion
    • Pathogenesis of bronchopulmonary dysplasia/chronic lung disease, and novel therapies
    • Pulmonary hypertension in bronchopulmonary dysplasia
    • Use of oxygen during initial stabilization phase and during hospital stay in neonates
    • Treatment of air leak syndrome
  • CPAP in preterm and term infants: Venkat Kakkilaya, Vishal Kapadia, Myra Wyckoff, Luc Brion, Lorraine Baustista
    • Randomized study comparing two modes of weaning CPAP
    • Use of less invasive surfactant administration (LISA)
    • CPAP vs. intubation in the delivery room in preterm infants
    • CPAP failure
    • Association between CPAP in delivery room and air leak in late-preterm and term neonates
  • Cardiovascular System and metabolic syndrome: Mambarambath Jaleel, Phil Shaul, Noorjahan Ali, Luc Brion
    • Potential risk of metabolic syndrome in infancy among very low birth weight infants:Evidence for abnormal weight-to-length ratio, increased adiposity, glomerular hyperfiltration and high blood pressure in very low birth weight infants followed at the Thrive Clinic and beyond the first decade of life
    • Patent ductus arteriosus
    • Nutritional interventions to prevent disproportionate growth
    • Simulation curriculum on delivery room and immediate postnatal management of cardiac lesions
  • Nutrition and growth: Eric Ortigoza, Pritha Nayak, Julie Mirpuri-Hathiramani, Katherine Stumpf, Luc Brion
    • Fish oil in short gut syndrome and neonatal cholestasis
    • Randomized Clinical Trial comparing individualized versus optimized supplementation of human milk in preterm infants
    • Multidisciplinary collaborative plan for optimizing breast milk and breast feeding while meeting nutritional needs, improving growth assessment and weight-length proportionality, improving neurodevelopment and reducing risk of metabolic syndrome in preterm infants
    • Prevention of hyperlipidemia
    • Necrotizing enterocolitis: risk factors, prevention
    • Intestinal rehabilitation program: comparison of type of enteral feeds on growth trajectory and time to full feeds in infants with intestinal failure
    • Long term neurodevelopmental outcome in infants with short gut
    • Urine sodium in infants with short gut
  • Neonatal infection, placenta pathology: Imran Mir, Lina Chalak, Shamaila Gill
    • Screening and Serial Neutrophil Counts in early and late neonatal sepsis
    • Fetal-placental crosstalk occurs through fetal cytokine synthesis and placental clearance
    • Antibiotic stewardship
  • Participation in NIH Neonatal Research Network: Myra Wyckoff (site PI), Luc Brion (alternate PI), Lina Chalak (hypoxic-ischemic encephalopathy), Mambarambath Jaleel (patent ductus arteriosus)
    • The Division of Neonatal-Perinatal Medicine is an active participant in the Neonatal Network randomized trials, observational and follow-up studies.
  • Development care and follow-up: 
    • Developmental follow-up of complex high-risk and very low birth weight infants and infants enrolled in NICHD NRN studies and internal studies
    • Community advocacy
    • Parental Perception of Child Vulnerability in the NICU and Developmental Outcomes: An Randomized Controlled Trial of Preventative Intervention with Cognitive Behavioral
    • Bayley language development in preterm infants with oral feeding difficulty
  • Neonatal Abstinence Syndrome: Venkat Kakkilaya, Lorraine Baustista
    • Predictors of Longer Length of Treatment for Infants with Neonatal Abstinence Syndrome
    • Assessment tools for drug withdrawal
    • Treatment of pain, sedation and withdrawal of therapy
  • Educational scholarship: Luc Brion
    • Improving Timeliness of Submission of Fellow Evaluations by Neonatology Faculty
    • Case of the week: Improving bedside teaching in the Parkland NICU
    • Improving completion of Fellow evaluations by parents
  • Observational studies using available databases: Myra Wyckoff, Luc Brion, Vishal Kapadia, Noorjahan Ali, Sushmita Yallapragada
    Several research studies and quality improvement projects use information from available databases, including:
    • The neonatal resuscitation databases [Parkland, Clements University Hospital (CUH)]
    • The neonatal resuscitation database at CMC
    • The NICU databases at Parkland and Children’s Medical Center (CMC)
    • The NICHD Neonatal Research Network Databases: Generic Database (Parkland, CUH), Follow-up Database, and Moderate Preterm Registry
    • The Vermont-Oxford Network (Parkland, Texas Health Resources and CUH NICU)
    • The Child Health Neonatal Consortium Database (CMC NICU): focus groups including congenital diaphragmatic hernia, resuscitation, pre/post op management, pain, bronchopulmonary dysplasia/pulmonary hypertension, necrotizing enterocolitis
  • Quality improvement (QI): Venkat Kakkilaya, Mambarambath Jaleel, Becky Ennis, Shamaila Gill, Noorjahan Ali, Luc Brion, Lorraine Baustista
    There is a significant amount of quality improvement occurring in all of our NICUs (see above).  Multiple QI projects are currently ongoing.  A sample of those projects include:
    • Improving non-invasive ventilation use in the delivery room (Parkland)
    • Improving number of attempts needed for successful intubation (CMC)
    • Reducing antibiotic utilization in late preterm and term infants suspected of early onset sepsis
    • Institution of TPN bundle to decrease triglyceride levels in preterm neonates; Decreasing rates of admission to the NICU for hypoglycemia (CUH)
    • Improving resuscitation of neonates beyond the delivery room (CMC)
    • Assessment of growth patterns using serial accurate length measurements in critical neonates
    • Clinical Safety and Efficacy (CSE) Course at UT Southwestern Medical Center

Abbreviations: CMC, Children’s Medical Center; CUH, Clements University Hospital
Revised 07-30-2024

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