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David Timothy H. Tanaka

Professor of Pediatrics
Pediatrics, Neonatology
Box 3179 Med Ctr, Durham, NC 27710
2424 Erwin Road, Hock Plaza Suite 504, Durham, NC 27710

Selected Publications


Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.

Journal Article J Perinatol · January 2024 OBJECTIVE: To describe the epidemiology, risk factors, and timing of spontaneous intestinal perforation (SIP) among infants born at 22-24 weeks' gestational age (GA). STUDY DESIGN: Observational cohort study among infants born at 22-24 weeks' GA in 446 neo ... Full text Link to item Cite

The association of placental pathology and neurodevelopmental outcomes in patients with neonatal encephalopathy.

Journal Article Pediatr Res · November 2023 BACKGROUND: Studies conflict on how acute versus chronic placental pathology impacts outcomes after neonatal encephalopathy from presumed hypoxic-ischemic encephalopathy (HIE). We examine how outcomes after presumed HIE vary by placental pathology categori ... Full text Link to item Cite

Early pumping frequency and coming to volume for mother's own milk feeding in hospitalized infants.

Journal Article J Perinatol · May 2023 OBJECTIVE: To identify daily pumping frequencies associated with coming to volume (CTV: producing > 500 milliliters of milk per day by postnatal day 14) for mothers of infants in the neonatal intensive care unit (NICU). STUDY DESIGN: We compared demographi ... Full text Link to item Cite

Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants.

Journal Article Arch Dis Child Fetal Neonatal Ed · June 21, 2022 OBJECTIVE: Develop an online estimator that accurately predicts bronchopulmonary dysplasia (BPD) severity or death using readily-available demographic and clinical data. DESIGN: Retrospective analysis of data entered into a prospective registry. SETTING: I ... Full text Link to item Cite

Comparison of short-term outcomes of 35-weeks' gestation infants cared for in a level II NICU vs mother-baby, a retrospective study.

Journal Article J Neonatal Perinatal Med · 2022 BACKGROUND: Late preterm infants are at high risk for medical complications and represent a growing NICU population. While 34-weeks' gestation infants are generally admitted to the NICU and 36-weeks'gestation infants stay in mother-baby, there is wide prac ... Full text Link to item Cite

Survival, Morbidities, and Developmental Outcomes among Low Birth Weight Infants with Congenital Heart Defects.

Journal Article Am J Perinatol · November 2021 OBJECTIVE: Prematurity and low birth weight (LBW) are risk factors for increased morbidity and mortality in infants with congenital heart defects (CHDs). We sought to describe survival, inhospital morbidities, and 2-year neurodevelopmental follow-up in LBW ... Full text Link to item Cite

Influence of Early Lactation Assistance on Inpatient Exclusive Breastfeeding Rates.

Journal Article J Hum Lact · August 2021 BACKGROUND: Human milk feeding reduces the incidence and costs of several maternal and childhood illnesses. Initiation and success of human milk feeding are influenced by race, socioeconomic status, and family support. The influence of early in-hospital la ... Full text Link to item Cite

Augmented Reality-Assisted Video Laryngoscopy and Simulated Neonatal Intubations: A Pilot Study.

Journal Article Pediatrics · March 2021 BACKGROUND: For novice providers, achieving competency in neonatal intubation is becoming increasingly difficult, possibly because of fewer intubation opportunities. In the present study, we compared intubation outcomes on manikins using direct laryngoscop ... Full text Link to item Cite

Attention-Based Network for Weak Labels in Neonatal Seizure Detection.

Journal Article Proc Mach Learn Res · August 2020 Seizures are a common emergency in the neonatal intesive care unit (NICU) among newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy. The high incidence of seizures in this patient population necessitates continuous electroencepha ... Link to item Cite

Patterns of phlebotomy blood loss and transfusions in extremely low birth weight infants.

Journal Article J Perinatol · December 2019 OBJECTIVE: Characterize frequency and volume of blood draws and transfusions in extremely low birth weight infants in the first 10 weeks of life. STUDY DESIGN: We included infants with a birth weight <1000 g born 23 0/7-29 6/7 weeks gestational age (GA) an ... Full text Link to item Cite

Augmented Reality (AR) Assisted Laryngoscopy for Endotracheal Intubation Training

Conference Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) · January 1, 2019 Medical trainees require sufficient practice to gain the experience and confidence needed to safely and reliably perform endotracheal intubations. While video laryngoscopy has been used to provide an advanced glottic view that can reduce intubation failure ... Full text Cite

Evaluation of the Financial and Health Burden of Infants at Risk for Respiratory Syncytial Virus.

Journal Article Adv Neonatal Care · August 2017 BACKGROUND: Respiratory syncytial virus (RSV) is the leading viral cause of death in infants younger than 1 year. In July 2014, the American Academy of Pediatrics (AAP) Committee on Infectious Diseases concluded that the "limited clinical benefit" for infa ... Full text Link to item Cite

A discrete event simulation tool to support and predict hospital and clinic staffing.

Journal Article Health Informatics J · June 2017 We demonstrate how to develop a simulation tool to help healthcare managers and administrators predict and plan for staffing needs in a hospital neonatal intensive care unit using administrative data. We developed a discrete event simulation model of nursi ... Full text Link to item Cite

Perfusion Index in Very Low Birth Weight Premature Infants During Their First 2 Weeks of Life.

Journal Article Biol Res Nurs · January 2017 BACKGROUND: Our program of research focuses on thermal and circulatory stability in extremely premature infants. In prior studies, we found that infants have long periods of time in which foot temperature (FT) is higher than central temperature. We thus wa ... Full text Link to item Cite

Negative Temperature Differential in Preterm Infants Less Than 29 Weeks Gestational Age: Associations With Infection and Maternal Smoking.

Journal Article Nurs Res · 2017 BACKGROUND: Hypothermia is related to increased morbidity and mortality in very preterm infants; continuous temperature monitoring is necessary. Thermoregulation is limited in preterm infants. OBJECTIVES: The purpose of the research was to assess and descr ... Full text Link to item Cite

Demonstrating the relationships of length of stay, cost and clinical outcomes in a simulated NICU.

Journal Article J Perinatol · December 2016 OBJECTIVE: Health-care leaders place significant focus on reducing the average length of stay (ALOS). We examined the relationships among ALOS, cost and clinical outcomes using a neonatal intensive care unit (NICU) simulation model. STUDY DESIGN: A discret ... Full text Link to item Cite

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit.

Journal Article Adv Neonatal Care · February 2016 BACKGROUND: Bloodstream infections (BSI) cause significant morbidity and mortality among hospitalized infants. PURPOSE: Reduction of BSIs has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line c ... Full text Link to item Cite

Medicaid policy changes and its detrimental effects on neonatal reimbursement and care

Journal Article Journal of Health Care Finance · September 1, 2015 BACKGROUND: In 2008, North Carolina Medicaid changed the way it classified neonatal care by adopting the Centers for Medicare & Medicaid Services Medicare Severity Diagnosis Related Group (MS-DRG) classification system. By changing the classification syste ... Cite

Predicting neonatal intubation competency in trainees.

Journal Article Pediatrics · May 2015 BACKGROUND AND OBJECTIVES: Pediatric residency training programs are graduating residents who are not competent in neonatal intubation, a vital skill needed for any pediatrician involved in delivery room resuscitations. However, a precise definition of com ... Full text Link to item Cite

Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.

Journal Article J Perinatol · January 2024 OBJECTIVE: To describe the epidemiology, risk factors, and timing of spontaneous intestinal perforation (SIP) among infants born at 22-24 weeks' gestational age (GA). STUDY DESIGN: Observational cohort study among infants born at 22-24 weeks' GA in 446 neo ... Full text Link to item Cite

The association of placental pathology and neurodevelopmental outcomes in patients with neonatal encephalopathy.

Journal Article Pediatr Res · November 2023 BACKGROUND: Studies conflict on how acute versus chronic placental pathology impacts outcomes after neonatal encephalopathy from presumed hypoxic-ischemic encephalopathy (HIE). We examine how outcomes after presumed HIE vary by placental pathology categori ... Full text Link to item Cite

Early pumping frequency and coming to volume for mother's own milk feeding in hospitalized infants.

Journal Article J Perinatol · May 2023 OBJECTIVE: To identify daily pumping frequencies associated with coming to volume (CTV: producing > 500 milliliters of milk per day by postnatal day 14) for mothers of infants in the neonatal intensive care unit (NICU). STUDY DESIGN: We compared demographi ... Full text Link to item Cite

Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants.

Journal Article Arch Dis Child Fetal Neonatal Ed · June 21, 2022 OBJECTIVE: Develop an online estimator that accurately predicts bronchopulmonary dysplasia (BPD) severity or death using readily-available demographic and clinical data. DESIGN: Retrospective analysis of data entered into a prospective registry. SETTING: I ... Full text Link to item Cite

Comparison of short-term outcomes of 35-weeks' gestation infants cared for in a level II NICU vs mother-baby, a retrospective study.

Journal Article J Neonatal Perinatal Med · 2022 BACKGROUND: Late preterm infants are at high risk for medical complications and represent a growing NICU population. While 34-weeks' gestation infants are generally admitted to the NICU and 36-weeks'gestation infants stay in mother-baby, there is wide prac ... Full text Link to item Cite

Survival, Morbidities, and Developmental Outcomes among Low Birth Weight Infants with Congenital Heart Defects.

Journal Article Am J Perinatol · November 2021 OBJECTIVE: Prematurity and low birth weight (LBW) are risk factors for increased morbidity and mortality in infants with congenital heart defects (CHDs). We sought to describe survival, inhospital morbidities, and 2-year neurodevelopmental follow-up in LBW ... Full text Link to item Cite

Influence of Early Lactation Assistance on Inpatient Exclusive Breastfeeding Rates.

Journal Article J Hum Lact · August 2021 BACKGROUND: Human milk feeding reduces the incidence and costs of several maternal and childhood illnesses. Initiation and success of human milk feeding are influenced by race, socioeconomic status, and family support. The influence of early in-hospital la ... Full text Link to item Cite

Augmented Reality-Assisted Video Laryngoscopy and Simulated Neonatal Intubations: A Pilot Study.

Journal Article Pediatrics · March 2021 BACKGROUND: For novice providers, achieving competency in neonatal intubation is becoming increasingly difficult, possibly because of fewer intubation opportunities. In the present study, we compared intubation outcomes on manikins using direct laryngoscop ... Full text Link to item Cite

Attention-Based Network for Weak Labels in Neonatal Seizure Detection.

Journal Article Proc Mach Learn Res · August 2020 Seizures are a common emergency in the neonatal intesive care unit (NICU) among newborns receiving therapeutic hypothermia for hypoxic ischemic encephalopathy. The high incidence of seizures in this patient population necessitates continuous electroencepha ... Link to item Cite

Patterns of phlebotomy blood loss and transfusions in extremely low birth weight infants.

Journal Article J Perinatol · December 2019 OBJECTIVE: Characterize frequency and volume of blood draws and transfusions in extremely low birth weight infants in the first 10 weeks of life. STUDY DESIGN: We included infants with a birth weight <1000 g born 23 0/7-29 6/7 weeks gestational age (GA) an ... Full text Link to item Cite

Augmented Reality (AR) Assisted Laryngoscopy for Endotracheal Intubation Training

Conference Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) · January 1, 2019 Medical trainees require sufficient practice to gain the experience and confidence needed to safely and reliably perform endotracheal intubations. While video laryngoscopy has been used to provide an advanced glottic view that can reduce intubation failure ... Full text Cite

Evaluation of the Financial and Health Burden of Infants at Risk for Respiratory Syncytial Virus.

Journal Article Adv Neonatal Care · August 2017 BACKGROUND: Respiratory syncytial virus (RSV) is the leading viral cause of death in infants younger than 1 year. In July 2014, the American Academy of Pediatrics (AAP) Committee on Infectious Diseases concluded that the "limited clinical benefit" for infa ... Full text Link to item Cite

A discrete event simulation tool to support and predict hospital and clinic staffing.

Journal Article Health Informatics J · June 2017 We demonstrate how to develop a simulation tool to help healthcare managers and administrators predict and plan for staffing needs in a hospital neonatal intensive care unit using administrative data. We developed a discrete event simulation model of nursi ... Full text Link to item Cite

Perfusion Index in Very Low Birth Weight Premature Infants During Their First 2 Weeks of Life.

Journal Article Biol Res Nurs · January 2017 BACKGROUND: Our program of research focuses on thermal and circulatory stability in extremely premature infants. In prior studies, we found that infants have long periods of time in which foot temperature (FT) is higher than central temperature. We thus wa ... Full text Link to item Cite

Negative Temperature Differential in Preterm Infants Less Than 29 Weeks Gestational Age: Associations With Infection and Maternal Smoking.

Journal Article Nurs Res · 2017 BACKGROUND: Hypothermia is related to increased morbidity and mortality in very preterm infants; continuous temperature monitoring is necessary. Thermoregulation is limited in preterm infants. OBJECTIVES: The purpose of the research was to assess and descr ... Full text Link to item Cite

Demonstrating the relationships of length of stay, cost and clinical outcomes in a simulated NICU.

Journal Article J Perinatol · December 2016 OBJECTIVE: Health-care leaders place significant focus on reducing the average length of stay (ALOS). We examined the relationships among ALOS, cost and clinical outcomes using a neonatal intensive care unit (NICU) simulation model. STUDY DESIGN: A discret ... Full text Link to item Cite

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit.

Journal Article Adv Neonatal Care · February 2016 BACKGROUND: Bloodstream infections (BSI) cause significant morbidity and mortality among hospitalized infants. PURPOSE: Reduction of BSIs has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line c ... Full text Link to item Cite

Medicaid policy changes and its detrimental effects on neonatal reimbursement and care

Journal Article Journal of Health Care Finance · September 1, 2015 BACKGROUND: In 2008, North Carolina Medicaid changed the way it classified neonatal care by adopting the Centers for Medicare & Medicaid Services Medicare Severity Diagnosis Related Group (MS-DRG) classification system. By changing the classification syste ... Cite

Predicting neonatal intubation competency in trainees.

Journal Article Pediatrics · May 2015 BACKGROUND AND OBJECTIVES: Pediatric residency training programs are graduating residents who are not competent in neonatal intubation, a vital skill needed for any pediatrician involved in delivery room resuscitations. However, a precise definition of com ... Full text Link to item Cite

Antenatal magnesium sulfate and spontaneous intestinal perforation in infants less than 25 weeks gestation.

Journal Article J Perinatol · November 2014 OBJECTIVE: Evaluate spontaneous intestinal perforation (SIP)/death among extremely low birthweight (ELBW) infants before, during and after initiation of an antenatal magnesium for neuroprotection protocol (MgPro). STUDY DESIGN: We tested associations betwe ... Full text Link to item Cite

Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis.

Journal Article Early Hum Dev · May 2014 AIMS: The objective of this study is to determine the incidence of and risk factors for necrotizing enterocolitis (NEC) and transfusion-associated NEC (TANEC) in very-low-birth-weight (VLBW) infants pre/post implementation of a peri-transfusion feeding pro ... Full text Link to item Cite

The relationship between black race, maternal infection and NEC in the preterm infant

Journal Article Newborn and Infant Nursing Reviews · December 1, 2013 Higher rates of necrotizing enterocolitis (NEC) in black preterm infants have been attributed to the higher rates of preterm delivery in this population. The focus however has been on preterm infant risk factors with minimal investigation into the contribu ... Full text Cite

Relationship of neonatal treatments with the development of necrotizing enterocolitis in preterm infants.

Journal Article Nurs Res · 2012 BACKGROUND: Although many therapeutic interventions are necessary for the survival of the preterm infant, understanding the potential effects of these treatments is important to decrease the rate of necrotizing enterocolitis (NEC) in preterm infants. OBJEC ... Full text Link to item Cite

Infrared thermal imaging (thermography) of the abdomen in extremely low birthweight infants.

Journal Article Journal of Surgical Radiology · October 2010 Introduction. Infrared thermal imaging (thermography) is a non-invasive method to measure skin temperature. The primary aim of this study was to examine the feasibility of thermography for the assessment of abdominal skin temperature in extremely low birth ... Link to item Cite

Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness.

Journal Article J Am Med Inform Assoc · 2010 Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopt ... Full text Link to item Cite

Effect of methicillin-resistant Staphylococcus aureus colonization in the neonatal intensive care unit on total hospital cost.

Journal Article Infect Control Hosp Epidemiol · April 2009 The rate of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing in neonatal intensive care units. We determined the economic impact of isolating and cohorting MRSA-colonized neonates on total hospital cost at a 49-bed, level III-IV n ... Full text Link to item Cite

Methicillin-resistant Staphylococcus aureus outbreak in an intensive care nursery: potential for interinstitutional spread.

Journal Article Pediatr Infect Dis J · August 2007 BACKGROUND: After surveillance surveys documented the absence of methicillin-resistant Staphylococcus aureus (MRSA) in our intensive care nursery, an outbreak of MRSA infection occurred there during a 7-month period in 2005. METHODS: Control measures inclu ... Full text Link to item Cite

Anti-neutrophil chemokine preserves alveolar development in hyperoxia-exposed newborn rats.

Journal Article Am J Physiol Lung Cell Mol Physiol · August 2001 Inflammation may contribute to lung injury and impaired alveolar development in bronchopulmonary dysplasia. We treated hyperoxia-exposed newborn rats with antibodies to the neutrophil chemokine cytokine-induced neutrophil chemoattractant-1 (CINC-1) during ... Full text Link to item Cite

The effects of bedside blood gas monitoring on blood loss and ventilator management.

Journal Article Biol Neonate · 2001 INTRODUCTION: We examined whether the bedside SensiCath Blood Gas Monitoring System could reduce both blood loss and the time needed to make ventilator-setting changes in a population of very low birth weight (VLBW; <1,500 g) infants. MATERIAL AND METHODS: ... Full text Link to item Cite

Neurokinin subtype receptors mediating substance P contraction in immature rabbit airways.

Journal Article Pediatr Res · January 1996 Two-week-old rabbit tracheal smooth muscle (TSM) and bronchial smooth muscle (BSM) segments were placed in organ baths, and isometric contractions to substance P (SP) were obtained. In the presence of phosphoramidon (PHOS), a neutral endopeptidase inhibito ... Full text Link to item Cite

Neuromodulation mediated by neurokinin-1 subtype receptors in adult rabbit airways.

Journal Article Am J Physiol · September 1993 The neuromodulatory actions of Septide, a selective neurokinin-1 (NK-1) agonist, and substance P (SP) were investigated in isolated rabbit tracheal smooth muscle (TSM) segments. The tissues were placed in organ baths containing modified Krebs-Ringer soluti ... Full text Link to item Cite

The effect of chlorothiazide on neurally mediated contraction of rabbit bronchial smooth muscle.

Journal Article Am Rev Respir Dis · January 1992 The neuromodulatory action of chlorothiazide (CTZ) was investigated in isolated rabbit bronchial smooth muscle (BSM) segments contracted with electrical field stimulation (ES). The tissues were placed in organ baths and stimulated with ES frequencies rangi ... Full text Link to item Cite

Cholinergic mechanisms involved with histamine hyperreactivity in immune rabbit airways challenged with ragweed antigen.

Journal Article Am Rev Respir Dis · July 1991 The present study examines the effects of aerosolized ragweed antigen (RAg) on tracheal (TSM) and bronchial (BSM) smooth muscle contraction in rabbits actively immunized with RAg. Airway segments were isolated 48 h after aerosol challenge with either salin ... Full text Link to item Cite

Effect of cooling on the responsiveness of canine tracheal muscle.

Journal Article Am Rev Respir Dis · December 1990 Airway cooling causes bronchoconstriction in many persons who have asthma. To determine the direct effect of cooling on the response of tracheal muscle to parasympathetic and muscarinic stimuli in situ, the temperature of a segment of canine cervical trach ... Full text Link to item Cite

Neurokinin receptors mediating substance P-induced contraction in adult rabbit airways.

Journal Article Am J Physiol · February 1990 Airway contractile responses to substance P (SP) were examined in isolated adult rabbit bronchial (BSM) and tracheal smooth muscle (TSM) segments. The tissues were placed in organ baths containing modified Krebs-Ringer solution, and isometric contractions ... Full text Link to item Cite

Maturation of neuromodulatory effect of substance P in rabbit airways.

Journal Article The Journal of clinical investigation · February 1990 The maturation of the neuromodulatory action of substance P (SP) was investigated in tracheal smooth muscle (TSM) segments isolated from rabbits aged 2-24 wk. The tissues were placed in baths containing Krebs-Ringer solution and contracted with electrical ... Full text Cite

Effects of temperature on cholinergic contractility of rabbit airway muscle.

Journal Article J Appl Physiol (1985) · November 1987 To elucidate the mechanism underlying temperature-induced changes in airway cholinergic contractility, the effects of organ bath cooling were evaluated in isolated rabbit airway smooth muscle (ASM) segments isometrically contracted with methacholine (METH) ... Full text Link to item Cite

Effect of substance P on neurally mediated contraction of rabbit airway smooth muscle.

Journal Article J Appl Physiol (1985) · February 1986 The neuromodulatory action of substance P (SP) was investigated in isolated rabbit tracheal smooth muscle (TSM) segments contracted with electrical field stimulation (ES). The tissues were placed in organ baths containing modified Krebs-Ringer solution and ... Full text Link to item Cite

Ontogeny of respiratory control and pulmonary mechanics in newborn rabbits.

Journal Article J Appl Physiol (1985) · November 1985 Maturation of the respiratory pattern and the active and passive mechanical properties of the respiratory system were assessed in 19 tracheotomized rabbits (postnatal age range: 1-26 days) placed in a body plethysmograph. With maturation both minute ventil ... Full text Link to item Cite

Opposing hemodynamic effects of substance P on pulmonary vasculature in rabbits.

Journal Article J Appl Physiol (1985) · October 1985 Substance P is a peptide implicated in the control of a variety of physiological processes. Although substance P-containing neurons impinge on the pulmonary vasculature, the effects of substance P on the pulmonary circulation have not been systematically i ... Full text Link to item Cite

Vasoactive effects of substance P on isolated rabbit pulmonary artery.

Journal Article J Appl Physiol (1985) · April 1985 The vasoactive properties of substance P (SP) were studied in isolated rabbit pulmonary artery (PA) segments in vitro. In the absence of active base-line tone, noncumulative administration of SP (10(-11) to 10(-4) M) produced dose-dependent increases in PA ... Full text Link to item Cite

Mechanisms of substance P-induced contraction of rabbit airway smooth muscle.

Journal Article J Appl Physiol Respir Environ Exerc Physiol · November 1984 The contractile effects of substance P (SP) were studied in isolated rabbit tracheal smooth muscle (TSM) segments in vitro. Noncumulative administration of SP produced dose-dependent increases in TSM tension. The mean (+/- SE) peak isometric tension (Tmax) ... Full text Link to item Cite

Mechanism of substance P-induced bronchoconstriction in maturing rabbit.

Journal Article J Appl Physiol Respir Environ Exerc Physiol · October 1984 The maturational effects of substance P (SP) on airway function were quantitatively assessed in 30 anesthetized tracheotomized rabbits ranging in age from 2 to 29 days. Following paralysis, during mechanical ventilation with 100% O2 in a body plethysmograp ... Full text Link to item Cite