Scholars@Duke
Rachel Gottron Greenberg

Rachel Gottron Greenberg

Associate Professor of Pediatrics
Pediatrics, Neonatology
rachel.greenberg@duke.edu
Box 2720 Med Ctr, Durham, NC 27710
DUMC 102509, Durham, NC 27710

Selected Publications

Trends in Gabapentin Use in Neonatal Intensive Care Units from 2005 to 2020.

Journal Article American journal of perinatology · November 2024 Objective This study aimed to analyze trends in gabapentin use in neonatal intensive care units (NICUs) and examine demographic characteristics, diagnoses, and concomitant medications associated with its use.Study design Cohort study of 9 ... Full text Cite

Neonatal Morbidities, Neurodevelopmental Impairments, and Positive Health among Children Surviving Birth before 32 Weeks of Gestation.

Journal Article J Pediatr · October 30, 2024 OBJECTIVES: To evaluate positive health outcomes among children born at < 32 weeks of gestation and to determine whether children with three common neonatal morbidities and 2 neurodevelopmental impairments would have similar positive health outcomes to chi ... Full text Link to item Cite

Pharmacoepidemiology of combination pulmonary vasodilator therapy in critically ill infants.

Journal Article Cardiol Young · October 16, 2024 BACKGROUND: New drugs to target different pathways in pulmonary hypertension has resulted in increased combination therapy, but details of this use in infants are not well described. In this large multicenter database study, we describe the pharmacoepidemi ... Full text Link to item Cite

Epidemiology and treatment of herpes simplex virus in the neonatal intensive care unit.

Journal Article J Perinatol · October 11, 2024 OBJECTIVE: Describe the epidemiology and clinical characteristics of infants in the neonatal intensive care unit (NICU) with acyclovir exposure and herpes simplex virus (HSV) infection. STUDY DESIGN: Our primary analysis was to evaluate the prevalence of H ... Full text Link to item Cite

Postdiscontinuation Antibiotic Exposure in Hospitalized Infants at Risk for Late-onset Sepsis in the Neonatal Intensive Care Unit.

Journal Article Pediatr Infect Dis J · October 1, 2024 BACKGROUND: In the neonatal intensive care unit, infants are at risk for late-onset sepsis. When blood cultures are negative, antibiotic stewardship efforts encourage stopping antibiotics, yet the duration of therapeutic exposure after the last dose is unk ... Full text Link to item Cite

Social needs and healthcare utilization in NICU graduates.

Journal Article J Perinatol · September 13, 2024 OBJECTIVE: Unplanned healthcare utilization after neonatal intensive care unit (NICU) discharge challenges families and healthcare systems. The impact of social needs on post-NICU healthcare utilization is underexplored. Our objective was to identify socia ... Full text Link to item Cite

The association of the room air challenge with long-term outcomes in extremely preterm infants.

Journal Article J Perinatol · September 2024 OBJECTIVE: Evaluate the association between results of the room air (RA) challenge and death, respiratory morbidity, and neurodevelopmental impairment (NDI) at 2 years' corrected age. STUDY DESIGN: Cohort study of infants born <27 weeks' gestational age wh ... Full text Link to item Cite

Methylxanthine use in infants with hypoxic-ischemic encephalopathy: a retrospective cohort study.

Journal Article Sci Rep · August 17, 2024 Therapeutic hypothermia is the standard treatment for hypoxic-ischemic encephalopathy (HIE), but despite its widespread use, the rates of mortality and neurodevelopmental impairment for moderate to severe HIE remain around 30%. Methylxanthines, such as caf ... Full text Link to item Cite

Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study.

Journal Article J Perinatol · August 5, 2024 OBJECTIVE: Characterize C-reactive protein (CRP) within 72 postnatal hours in early-onset sepsis (EOS). STUDY DESIGN: Secondary analysis of a prospective surveillance study of neonates with EOS 2015-2017. We examined CRP use by center and neonatal characte ... Full text Link to item Cite

Concordance of Cytomegalovirus Saliva and Urine Testing in Infants for the Detection of Congenital Infection.

Journal Article Pediatr Infect Dis J · August 2, 2024 Congenital cytomegalovirus is a leading cause of neurodevelopmental impairment and sensorineural hearing loss. We evaluated infants ≤21 days postnatal age who had both urine and saliva cytomegalovirus testing and determined concordance between the 2 tests ... Full text Link to item Cite

Physiologically-based pharmacokinetic modeling of pantoprazole to evaluate the role of CYP2C19 genetic variation and obesity in the pediatric population.

Journal Article CPT Pharmacometrics Syst Pharmacol · August 2024 Pantoprazole is a proton pump inhibitor indicated for the treatment of gastroesophageal reflux disease, a condition that disproportionately affects children with obesity. Appropriately dosing pantoprazole in children with obesity requires understanding the ... Full text Link to item Cite

Epidemiology and outcomes of bacterial meningitis in the neonatal intensive care unit.

Journal Article J Perinatol · July 26, 2024 OBJECTIVE: Examine pathogen distribution, antibiotic resistance patterns, and hospital outcomes of infants with bacterial meningitis in neonatal intensive care units (NICUs) in the US from 2013-2018. STUDY DESIGN: Infants were divided into 2 groups based o ... Full text Link to item Cite

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers.

Journal Article Am J Perinatol · July 2024 OBJECTIVE: Little is known about the hospital outcomes of moderately preterm (MPT; 29 0/7-33 6/7 weeks gestational age) infants born to insulin-dependent diabetic mothers (IDDMs). We evaluated characteristics and outcomes of MPT infants born to IDDMs compa ... Full text Link to item Cite

Prescribing practices of inhaled corticosteroids for premature infants in the neonatal intensive care unit.

Journal Article J Perinatol · July 2024 OBJECTIVE: Despite limited safety and efficacy data, inhaled corticosteroids (ICS) are prescribed to premature infants in the neonatal intensive care unit (NICU). We examined contemporary use and risk factors for ICS use in the NICU. STUDY DESIGN: Infants ... Full text Link to item Cite

Characterizing Enoxaparin's Population Pharmacokinetics to Guide Dose Individualization in the Pediatric Population.

Journal Article Clin Pharmacokinet · July 2024 BACKGROUND AND OBJECTIVE: Pediatric dosing of enoxaparin was derived based on extrapolation of the adult therapeutic range to children. However, a large fraction of children do not achieve therapeutic anticoagulation with initial dosing. We aim to use real ... Full text Link to item Cite

Acyclovir Dosing Practices Across a Multicenter Cohort of Neonatal Intensive Care Units.

Journal Article Pediatr Infect Dis J · June 26, 2024 BACKGROUND: Acyclovir is the first-line therapy for neonatal herpes simplex virus infections. Therapy can mitigate morbidity and mortality but carries a risk for toxicity. We aimed to compare acyclovir dosing in neonatal intensive care units to published r ... Full text Link to item Cite

Incidence of group B streptococcus early-onset sepsis in term neonates with second-line prophylaxis maternal intrapartum antibiotics: a multicenter retrospective study.

Journal Article Am J Obstet Gynecol · June 2024 BACKGROUND: The difference in the incidence of early-onset sepsis caused by group B streptococcus among term neonates whose mothers received first-line vs second-line intrapartum prophylaxis is poorly described. OBJECTIVE: This study aimed to compare the i ... Full text Link to item Cite

Association of maternal pre-pregnancy or first trimester body mass index with neurodevelopmental impairment or death in extremely low gestational age neonates.

Journal Article J Perinatol · June 2024 OBJECTIVE: To compare the rates of death or survival with severe neurodevelopmental impairment (sNDI) at 2 years among extremely preterm infants in relation to pre-pregnancy or first-trimester maternal body mass index (BMI). METHODS: This retrospective coh ... Full text Link to item Cite

Influence of Eat, Sleep, and Console on Infants Pharmacologically Treated for Opioid Withdrawal: A Post Hoc Subgroup Analysis of the ESC-NOW Randomized Clinical Trial.

Journal Article JAMA Pediatr · June 1, 2024 IMPORTANCE: The function-based eat, sleep, console (ESC) care approach substantially reduces the proportion of infants who receive pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS). This reduction has led to concerns for increased post ... Full text Link to item Cite

Indomethacin Prophylaxis in Preterm Infants: Changes over Time.

Journal Article Am J Perinatol · May 2024 OBJECTIVE: Our objective was to examine changes in the use of indomethacin prophylaxis in the neonatal intensive care unit (NICU) between 2008 and 2018. STUDY DESIGN: The design of the study included cohort of 19,715 infants born between 220/7 and 266/7 we ... Full text Link to item Cite

Insulin for Treatment of Neonatal Hyperglycemia in Premature Infants: Prevalence over Time and Association with Outcomes.

Journal Article Am J Perinatol · May 2024 OBJECTIVE: Our objective was to determine the prevalence of insulin treatment in premature infants with hyperglycemia and evaluate the association of length of treatment with outcomes. STUDY DESIGN: The study included cohort of 29,974 infants 22 to 32 week ... Full text Link to item Cite

Urinary Tract Infection Epidemiology in NICUs in the United States.

Journal Article Am J Perinatol · May 2024 OBJECTIVE: Our objective was to characterize the incidence, associated clinical factors, timing of infection, microbiology, and incidence of concordant blood culture of urinary tract infections (UTIs) in very low birth weight (VLBW <1,500g) infants. STUDY ... Full text Link to item Cite

Neonatal Necrotizing Enterocolitis: An Update on Pathophysiology, Treatment, and Prevention.

Journal Article Paediatr Drugs · May 2024 Necrotizing enterocolitis (NEC) is a life-threatening disease predominantly affecting premature and very low birth weight infants resulting in inflammation and necrosis of the small bowel and colon and potentially leading to sepsis, peritonitis, perforatio ... Full text Link to item Cite

Opportunistic dried blood spot sampling validates and optimizes a pediatric population pharmacokinetic model of metronidazole.

Journal Article Antimicrob Agents Chemother · April 3, 2024 Pharmacokinetic models rarely undergo external validation in vulnerable populations such as critically ill infants, thereby limiting the accuracy, efficacy, and safety of model-informed dosing in real-world settings. Here, we describe an opportunistic appr ... Full text Link to item Cite

A phase I trial of caffeine to evaluate safety in infants with hypoxic-ischemic encephalopathy.

Journal Article J Perinatol · April 2024 OBJECTIVE: Caffeine provides neuroprotection following hypoxic-ischemic injury in animals. We characterized the safety of escalating doses of caffeine in infants with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia. STUDY DESIGN: Ph ... Full text Link to item Cite

Direct-to-participant recruitment of mothers and infants: A strategic approach during challenging pandemic times.

Journal Article Contemp Clin Trials Commun · April 2024 Under traditional circumstances, most clinical trials rely on in-person operations to identify, recruit, and enroll study participants and to complete study-related visits. During unusual circumstances, such as the COVID-19 pandemic, the typical clinical t ... Full text Link to item Cite

Safety and Effectiveness of Probiotics in Preterm Infants with Necrotizing Enterocolitis.

Journal Article Neoreviews · April 1, 2024 Although necrotizing enterocolitis is a leading cause of morbidity and mortality among preterm infants, its underlying pathophysiology is not fully understood. Gut dysbiosis, an imbalance between commensal and pathogenic microbes, in the preterm infant is ... Full text Link to item Cite

Safety and Effectiveness of Probiotics in Preterm Infants with Necrotizing Enterocolitis.

Journal Article Neoreviews · April 1, 2024 Although necrotizing enterocolitis is a leading cause of morbidity and mortality among preterm infants, its underlying pathophysiology is not fully understood. Gut dysbiosis, an imbalance between commensal and pathogenic microbes, in the preterm infant is ... Full text Link to item Cite

Making the Most of Missing Data.

Journal Article Pediatrics · March 1, 2024 Full text Link to item Cite

Morbidity and mortality of twins and triplets compared to singleton infants delivered between 26-34 weeks gestation in the United States.

Journal Article J Perinatol · February 2024 OBJECTIVE: To describe in-hospital morbidities and mortality among twins and triplets delivered at ≥26 to ≤34 weeks gestational age (GA) while controlling for prematurity and growth restriction. STUDY DESIGN: Retrospective analysis of inborn infants discha ... Full text Link to item Cite

The Hassan Neonatal Morbidity Composite Scale and Neonatal Length of Stay-A Validation Study.

Journal Article Am J Perinatol · January 2024 OBJECTIVE: Obstetric studies often report neonatal morbidity as a composite score. Composite scores can simplify data analysis when multiple outcomes of interest are present and allows researchers to conduct smaller, more manageable trials. The Hassan scal ... Full text Link to item Cite

Trends in COVID-19 diagnoses and outcomes in infants hospitalized in the neonatal intensive care unit.

Journal Article J Perinatol · January 2024 OBJECTIVE: Characterize the prevalence of coronavirus disease 2019 (COVID-19) diagnosis among mothers with infants hospitalized in 294 neonatal intensive care units (NICUs), and demographics and outcomes of infants with severe acute respiratory syndrome co ... 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

Underimmunization of very low birth weight infants at discharge from the neonatal intensive care unit.

Journal Article J Perinatol · January 2024 OBJECTIVE: To quantify immunization status among premature infants discharged from neonatal intensive care units (NICUs), and identify risk factors for underimmunization. STUDY DESIGN: We performed a cohort study of infants <33 weeks gestation discharged h ... Full text Link to item Cite

Association Between Hypoglycemia and the Occurrence of Early Onset Sepsis in Premature Infants.

Journal Article J Pediatric Infect Dis Soc · December 26, 2023 BACKGROUND: We examined the association between hypoglycemia and the occurrence of early onset sepsis (EOS) in premature infants admitted to the neonatal intensive care unit (NICU). METHODS: We included infants discharged from 358 NICUs between 1997 and 20 ... Full text Link to item Cite

Diagnostic Utility of Cerebrospinal Fluid White Blood Cell Components for the Identification of Bacterial Meningitis in Infants.

Journal Article J Pediatric Infect Dis Soc · December 26, 2023 BACKGROUND: To evaluate the diagnostic and predictive utility of cerebrospinal fluid (CSF) white blood cell (WBC) components in the diagnosis of bacterial meningitis in infants discharged from the neonatal intensive care unit (NICU). METHODS: We identified ... Full text Link to item Cite

Late-Onset Sepsis Evaluation and Empiric Therapy in Extremely Low Gestational Age Newborns.

Journal Article J Pediatric Infect Dis Soc · December 26, 2023 BACKGROUND: Little is known about late-onset sepsis (LOS) evaluations in extremely low gestational age newborns (ELGANs). We describe frequencies of LOS evaluation in ELGANs, infant characteristics, and empiric therapy choices during evaluations. METHODS: ... Full text Link to item Cite

Generalizability of the Necrotizing Enterocolitis Surgery Trial to the Target Population of Eligible Infants.

Journal Article The Journal of pediatrics · November 2023 ObjectiveThe objective of this study was to evaluate whether infants randomized in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Necrotizing Enterocolitis Surgery Trial differed from ... Full text Cite

Trends in morbidities of late preterm infants in the neonatal intensive care unit.

Journal Article J Perinatol · November 2023 OBJECTIVE: To characterize demographics and trends in length of stay (LOS), morbidities, and mortality in late preterm infants. STUDY DESIGN: Cohort study of infants born between 34 0/7 and 36 6/7 weeks gestation between 1999 and 2018 without major congeni ... Full text Link to item Cite

Use of Dexmedetomidine and Opioids in Hospitalized Preterm Infants.

Journal Article JAMA Netw Open · November 1, 2023 IMPORTANCE: Dexmedetomidine, an α2-adrenergic agonist, is not approved by the Food and Drug Administration for use in premature infants. However, the off-label use of dexmedetomidine in premature infants has increased 50-fold in the past decade. Currently, ... Full text Link to item Cite

Updated Perspectives on the Diagnosis and Management of Neonatal Invasive Candidiasis

Journal Article Research and Reports in Neonatology · November 2023 Full text Cite

Use of vasopressors for septic shock in the neonatal intensive care unit.

Journal Article J Perinatol · October 2023 OBJECTIVE: To describe outcomes for infants in the neonatal intensive care unit with septic shock based on the vasopressor administered. METHODS: This is a multicenter cohort study of infants with an episode of septic shock. We evaluated the primary outcom ... Full text Link to item Cite

Early antibiotic exposure in very-low birth weight infants and infection risk at 3-7 days after birth.

Journal Article J Perinatol · September 2023 OBJECTIVE: To determine rates of late-onset infection (LOI) during postnatal days 3-7 among preterm infants, based on antibiotic exposure during days 0-2. STUDY DESIGN: Retrospective cohort study of infants born <1500 grams and ≤30 weeks gestation, 2005-20 ... Full text Link to item Cite

Pragmatic, randomized, blinded trial to shorten pharmacologic treatment of newborns with neonatal opioid withdrawal syndrome (NOWS).

Journal Article Trials · July 21, 2023 BACKGROUND: The incidence of maternal opioid use in the USA has increased substantially since 2000. As a consequence of opioid use during pregnancy, the incidence of neonatal opioid withdrawal syndrome (NOWS) has increased fivefold between 2002 and 2012. P ... Full text Link to item Cite

Association of patent ductus arteriosus with extubation failure among preterm infants.

Journal Article Pediatr Pulmonol · July 2023 BACKGROUND: Mechanical ventilation is associated with mortality/morbidities in preterm infants. Nearly a third of these infants fail extubation, and this may increase morbidities. OBJECTIVE: To evaluate the association of moderate to large symptomatic pate ... Full text Link to item Cite

Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal.

Journal Article N Engl J Med · June 22, 2023 BACKGROUND: Although clinicians have traditionally used the Finnegan Neonatal Abstinence Scoring Tool to assess the severity of neonatal opioid withdrawal, a newer function-based approach - the Eat, Sleep, Console care approach - is increasing in use. Whet ... Full text Link to item Cite

A Pilot Phase I Trial of Allogeneic Umbilical Cord Tissue-Derived Mesenchymal Stromal Cells in Neonates With Hypoxic-Ischemic Encephalopathy.

Journal Article Stem Cells Transl Med · June 15, 2023 Hypoxic ischemic encephalopathy (HIE) in neonates causes increased mortality and long-term morbidity in surviving babies. Hypothermia (HT) has improved outcomes, however, mortality remains high with ~half of surviving babies developing neurological impairm ... Full text Link to item Cite

Endotoxin content in neonatal formulas, fortification, and lactoferrin products: association with outcomes and guidance on acceptable limits.

Journal Article Biometals · June 2023 While endotoxin (lipopolysaccharide) can be harmful and contribute to morbidity and mortality with Gram-negative sepsis or necrotizing enterocolitis in preterm infants, non-toxic amounts are produced as part of the neonatal microbiome and may be present in ... Full text Link to item Cite

Dexmedetomidine Opioid Sparing Effect in Mechanically Ventilated Children (DOSE): Trial of Fentanyl versus Fentanyl + Dexmedetomidine for Maintenance of Sedation

Journal Article Journal of Pediatric Intensive Care · May 26, 2023 Abstract Objectives This article observes the mean daily dose of fentanyl required for adequate sedation in critically ill, mechanically ventilated children randomized to receive dexmedetomidine or placebo. Full text Cite

Assessment of Corticosteroid Therapy and Death or Disability According to Pretreatment Risk of Death or Bronchopulmonary Dysplasia in Extremely Preterm Infants.

Journal Article JAMA network open · May 2023 ImportanceMeta-analyses suggest that corticosteroids may be associated with increased survival without cerebral palsy in infants at high risk of bronchopulmonary dysplasia (BPD) but are associated with adverse neurologic outcomes in low-risk infan ... Full text Cite

Pharmacokinetic and pharmacodynamic principles: unique considerations for optimal design of neonatal clinical trials

Journal Article Frontiers in Pediatrics · February 10, 2023 Core clinical pharmacology principles must be considered when designing and executing neonatal clinical trials. In this review, the authors discuss important aspects of drug dose selection, pharmacokinetics, pharmacogenetics and pharmacodynamics that stake ... Full text Cite

Mechanisms to expedite pediatric clinical trial site activation: The DOSE trial experience.

Journal Article Contemp Clin Trials · February 2023 BACKGROUND: Timely trial start-up is a key determinant of trial success; however, delays during start-up are common and costly. Moreover, data on start-up metrics in pediatric clinical trials are sparse. To expedite trial start-up, the Trial Innovation Net ... Full text Link to item Cite

Congenital anomalies of the kidney and urinary tract (CAKUT) in critically ill infants: a multicenter cohort study.

Journal Article Pediatr Nephrol · January 2023 BACKGROUND: The aim of the study was to determine the prevalence of congenital anomalies of the kidney and urinary tract (CAKUT) in the neonatal intensive care unit (NICU) and to evaluate risk factors associated with worse outcomes. We hypothesized that in ... Full text Link to item Cite

Exposure-response Relationships of Metronidazole in Infants: Integration of Electronic Health Record Data With Population Pharmacokinetic Modeling-derived Exposure Simulation.

Journal Article Pediatr Infect Dis J · January 1, 2023 BACKGROUND: Infants frequently receive metronidazole at variable doses and duration for surgical site infection prophylaxis and treatment of intra-abdominal infections. Seizures are a rare (but potentially devastating) side effect of metronidazole, yet the ... Full text Link to item Cite

Evaluation and validation of a prediction model for extubation success in very preterm infants.

Journal Article J Perinatol · December 2022 OBJECTIVE: To perform an external validation of a publicly available model predicting extubation success in very preterm infants. STUDY DESIGN: Retrospective study of infants born <1250 g at a single center. Model performance evaluated using the area under ... Full text Link to item Cite

Safety of sildenafil in premature infants at risk of bronchopulmonary dysplasia: Rationale and methods of a phase II randomized trial.

Journal Article Contemp Clin Trials Commun · December 2022 Bronchopulmonary dysplasia (BPD) is a disease of chronic respiratory insufficiency stemming from premature birth and iatrogenic lung injury leading to alveolar simplification, impaired alveolar-capillary development, interstitial fibrosis, and often pulmon ... Full text Link to item Cite

Incidence of and Neurodevelopmental Outcomes After Late-Onset Meningitis Among Children Born Extremely Preterm.

Journal Article JAMA Netw Open · December 1, 2022 IMPORTANCE: Late-onset meningitis (LOM) has been associated with adverse neurodevelopmental outcomes in children born extremely preterm. OBJECTIVE: To report the incidence of LOM during birth hospitalization and neurodevelopmental outcomes at 18 to 26 mont ... Full text Link to item Cite

Pediatric Clinical Research Networks: Role in Accelerating Development of Therapeutics in Children.

Journal Article Ther Innov Regul Sci · November 2022 BACKGROUND: Recent decades have seen many advances in policy and legislation that support the development of drugs used by neonates, infants, children, and young people. This review summarizes the characteristics and performance of networks capable of cond ... Full text Link to item Cite

Group B Streptococcus Infection in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years.

Journal Article Clin Infect Dis · October 12, 2022 BACKGROUND: This study was performed to determine the incidence of group B Streptococcus (GBS) disease among extremely preterm infants and assess to risk of death or neurodevelopmental impairment (NDI) at a corrected age of 18-26 months. METHODS: In this o ... Full text Link to item Cite

Indomethacin Prophylaxis in Preterm Infants: Changes over Time.

Journal Article Am J Perinatol · September 29, 2022 OBJECTIVE:  Our objective was to examine changes in the use of indomethacin prophylaxis in the neonatal intensive care unit (NICU) between 2008 and 2018. STUDY DESIGN:  The design of the study included cohort of 19,715 infants born between 220/7 and 266/7 ... Full text Link to item Cite

Association of Antenatal Steroid Exposure at 21 to 22 Weeks of Gestation With Neonatal Survival and Survival Without Morbidities.

Journal Article JAMA Netw Open · September 1, 2022 IMPORTANCE: The provision of antenatal corticosteroids to pregnant patients at gestational age (GA) 22 6/7 weeks or less remains controversial and lacks support from randomized clinical trials. OBJECTIVE: To compare rates of survival and survival without m ... Full text Link to item Cite

Safety and Pharmacokinetics of Exebacase in an Infant With Disseminated Staphylococcus aureus Infection.

Journal Article Clin Infect Dis · August 25, 2022 Exebacase, an antistaphylococcal lysin produced from a bacteriophage-encoded gene, is a promising adjunctive therapy for severe methicillin-resistant Staphylococcus aureus infections. We describe the first infant to receive exebacase, dosing, and pharmacok ... Full text Open Access Link to item Cite

Ampicillin dosing in premature infants for early-onset sepsis: exposure-driven efficacy, safety, and stewardship.

Journal Article J Perinatol · July 2022 OBJECTIVE: Define optimal ampicillin dosing for empiric early-onset sepsis (EOS) therapy in preterm neonates. STUDY DESIGN: We simulated ampicillin concentrations in newborns (birthweight < 1500 g; gestational age 22-27 weeks), summarizing three 48 h regim ... 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

Pharmacodynamics of Meropenem and Tobramycin for Neonatal Meningoencephalitis: Novel Approaches to Facilitate the Development of New Agents to Address the Challenge of Antimicrobial Resistance.

Journal Article Antimicrob Agents Chemother · April 19, 2022 Neonatal sepsis is an underrecognized burden on health care systems throughout the world. Antimicrobial drug resistance (AMR) is increasingly prevalent and compromises the use of currently recommended first-line agents. The development of new antimicrobial ... Full text Link to item Cite

Association between postmenstrual age and furosemide dosing practices in very preterm infants.

Journal Article J Perinatol · April 2022 OBJECTIVE: Furosemide renal clearance is slow after very preterm (VP) birth and increases with postnatal maturation. We compared furosemide dose frequency and total daily dose between postmenstrual age (PMA) groups in VP infants. STUDY DESIGN: Observationa ... Full text Link to item Cite

Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.

Journal Article J Pediatr · March 2022 OBJECTIVES: To identify risk factors associated with mortality for infants receiving dialysis in the neonatal intensive care unit (NICU). STUDY DESIGN: In this retrospective cohort study, we extracted data from the Pediatrix Clinical Data Warehouse on all ... Full text Link to item Cite

Population Pharmacokinetics of Moxifloxacin in Children.

Journal Article Paediatr Drugs · March 2022 BACKGROUND/OBJECTIVE: Moxifloxacin is a fluoroquinolone that is commonly used in adults, but not children. Certain clinical situations compel pediatric clinicians to use moxifloxacin, despite its potential for toxicity and limited pharmacokinetics (PK) dat ... Full text Link to item Cite

Medication Use in the Neonatal Intensive Care Unit and Changes from 2010 to 2018.

Journal Article J Pediatr · January 2022 OBJECTIVE: To provide up-to-date medication prescribing patterns in US neonatal intensive care units (NICUs) and to examine trends in prescribing patterns over time. STUDY DESIGN: We performed a cohort study of 799 016 infants treated in NICUs managed by t ... Full text Link to item Cite

Neonatal invasive candidiasis: updates on clinical management and prevention.

Journal Article Lancet Child Adolesc Health · January 2022 Neonatal invasive candidiasis is an important cause of morbidity and mortality in preterm infants. The incidence of invasive candidiasis in this population has been declining in high-income settings, largely due to preventive measures, although there are s ... Full text Link to item Cite

Contemporary Trends in Global Mortality of Sepsis Among Young Infants Less Than 90 Days: A Systematic Review and Meta-Analysis.

Journal Article Front Pediatr · 2022 OBJECTIVE: Current knowledge on the global burden of infant sepsis is limited to population-level data. We aimed to summarize global case fatality rates (CFRs) of young infants with sepsis, stratified by gross national income (GNI) status and patient-level ... Full text Link to item Cite

Physiologically Based Pharmacokinetic Modeling of Meropenem in Preterm and Term Infants.

Conference Clin Pharmacokinet · December 2021 BACKGROUND: Meropenem is a broad-spectrum carbapenem antibiotic approved by the US Food and Drug Administration for use in pediatric patients, including treating complicated intra-abdominal infections in infants < 3 months of age. The impact of maturation ... Full text Link to item Cite

Neurosurgical procedures for children with myelomeningocele after fetal or postnatal surgery: a comparative effectiveness study.

Journal Article Dev Med Child Neurol · November 2021 AIM: To compare the frequencies of neurosurgical procedures to treat comorbid conditions of myelomeningocele in patients who underwent fetal surgery versus postnatal surgery for closure of the placode. METHOD: By utilizing the National Spina Bifida Patient ... Full text Link to item Cite

Comparative efficacy and safety of late surfactant preparations: a retrospective study.

Journal Article J Perinatol · November 2021 OBJECTIVE: Characterize the use, efficacy, and safety of poractant alfa and calfactant surfactants compared to beractant in preterm infants receiving late surfactant. STUDY DESIGN: We included infants <37 weeks gestational age (GA) discharged from Pediatri ... Full text Link to item Cite

Covariation of changing patent ductus arteriosus management and preterm infant outcomes in Pediatrix neonatal intensive care units.

Journal Article J Perinatol · October 2021 OBJECTIVE: To test the hypothesis that NICU-specific preterm infant outcomes co-vary with changes in local patent ductus arteriosus (PDA) management. STUDY DESIGN: This retrospective multicenter study examined NICU-specific aggregated data for infants born ... Full text Link to item Cite

Neurodevelopmental outcomes following neonatal late-onset sepsis and blood culture-negative conditions.

Journal Article Arch Dis Child Fetal Neonatal Ed · September 2021 OBJECTIVE: Determine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC). DESIGN: Retrospective cohort study. SETTING: 24 neonatal cen ... Full text Link to item Cite

Vasoactive medications in extremely low gestational age neonates during the first postnatal week.

Journal Article J Perinatol · September 2021 OBJECTIVE: The management of early hypotension in extremely low gestational age neonates (ELGANs) varies greatly between centers. The objective of this study was to provide updated data on the use of vasoactive medications in ELGANs during the first postna ... Full text Link to item Cite

Should Vitamin A Injections to Prevent Bronchopulmonary Dysplasia or Death Be Reserved for High-Risk Infants? Reanalysis of the National Institute of Child Health and Human Development Neonatal Research Network Randomized Trial.

Journal Article J Pediatr · September 2021 OBJECTIVE: To determine whether infants at higher risk of bronchopulmonary dysplasia (BPD) or death benefit more from vitamin A therapy than those at lower risk. STUDY DESIGN: We conducted a post hoc reanalysis of a landmark phase III randomized controlled ... Full text Link to item Cite

Discharging Medically Complex Infants with Supplemental Nasogastric Tube Feeds: Impact on Neonatal Intensive Care Unit Length of Stay and Prevention of Gastrostomy Tubes.

Journal Article Am J Perinatol · August 2021 OBJECTIVE: The aim of this study is to evaluate the feasibility, safety, and efficacy of discharge with supplemental nasogastric tube (NGT) feeds in medically complex infants. STUDY DESIGN: Cohort study of 400 infants enrolled in the Transitional Medical H ... Full text Link to item Cite

Association between neonatal intensive care unit medication safety practices, adverse events, and death.

Journal Article J Perinatol · July 2021 OBJECTIVE: Determine the associations between neonatal intensive care unit (NICU) medication safety practices, laboratory-based adverse events (lab-AEs), and death. STUDY DESIGN: We combined data from a 2016 survey of Pediatrix NICUs on use of medication s ... Full text Link to item Cite

Respiratory setback associated with extubation failure in extremely preterm infants.

Journal Article Pediatr Pulmonol · July 2021 BACKGROUND AND OBJECTIVES: Extubation failure in preterm infants is associated with an increased risk of mortality and morbidity. There is limited evidence to suggest if the increased morbidities are due to inherent differences among infants who fail or su ... Full text Link to item Cite

Long-term Outcomes after Postnatal Cytomegalovirus Infection in Low Birthweight Preterm Infants: A Systematic Review.

Journal Article Pediatr Infect Dis J · June 1, 2021 BACKGROUND: Cytomegalovirus (CMV) is the most common viral infection seen in newborns. Although postnatally acquired CMV (pCMV) infection rarely results in serious manifestations in term infants, preterm infants can develop severe clinical illness. However ... Full text Link to item Cite

Prolonged Post-Discontinuation Antibiotic Exposure in Very Low Birth Weight Neonates at Risk for Early-Onset Sepsis.

Journal Article J Pediatric Infect Dis Soc · May 28, 2021 BACKGROUND: Premature, very low birth weight (VLBW) neonates are at risk for early-onset sepsis and receive ampicillin and gentamicin post-birth. Antimicrobial stewardship supports short-course antibiotics, but how long antibiotic concentrations remain the ... Full text Link to item Cite

In-hospital mortality and morbidity among extremely preterm infants in relation to maternal body mass index.

Journal Article J Perinatol · May 2021 OBJECTIVE: The objective of this paper is to compare in-hospital survival and survival without major morbidities in extremely preterm infants in relation to maternal body mass index (BMI). METHODS: This retrospective cohort study included extremely preterm ... Full text Link to item Cite

Response of the trial innovation network to the COVID-19 pandemic.

Journal Article J Clin Transl Sci · April 20, 2021 INTRODUCTION: The COVID-19 pandemic prompted the development and implementation of hundreds of clinical trials across the USA. The Trial Innovation Network (TIN), funded by the National Center for Advancing Translational Sciences, was an established clinic ... Full text Link to item Cite

Association between Hyperbilirubinemia and Hearing Screen Failure in the Neonatal Intensive Care Unit in Infants Born Preterm.

Journal Article J Pediatr · April 2021 OBJECTIVE: To characterize the association between hyperbilirubinemia and a failed newborn hearing screen in infants born at 22-32 weeks of gestation. STUDY DESIGN: We included infants with gestational ages of 22-32 weeks who were discharged from neonatal ... Full text Link to item Cite

The use of supplemental hydrocortisone in the management of persistent pulmonary hypertension of the newborn.

Journal Article J Perinatol · April 2021 OBJECTIVE: Characterize association between hydrocortisone receipt and hospital outcomes of infants with persistent pulmonary hypertension of the newborn (PPHN). STUDY DESIGN: Cohort study of infants ≥34 weeks with PPHN who received inhaled nitric oxide at ... Full text Link to item Cite

Wide range of perioperative drugs and doses used in inguinal hernia repairs for premature infants.

Journal Article J Perinatol · March 2021 OBJECTIVE: Characterize the types and doses of commonly administered perioperative drugs in inguinal hernia (IH) repair for premature infants. STUDY DESIGN: Single-center, retrospective cohort study. RESULTS: In total, 112 premature infants underwent IH re ... 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

Thrombosis in infants in the neonatal intensive care unit: Analysis of a large national database.

Journal Article J Thromb Haemost · February 2021 BACKGROUND: Thrombosis in the neonatal population is rare, but increasing. Its incidence and management are not well understood. OBJECTIVES: To investigate the incidence, associated factors, and management of thrombosis in the neonatal intensive care unit ... Full text Link to item Cite

Association between Nephrotoxic Drug Combinations and Acute Kidney Injury in the Neonatal Intensive Care Unit.

Journal Article J Pediatr · January 2021 OBJECTIVE: To determine the incidence of acute kidney injury (AKI) in infants exposed to nephrotoxic drug combinations admitted to 268 neonatal intensive care units managed by the Pediatrix Medical Group. STUDY DESIGN: We included infants born at 22-36 wee ... Full text Link to item Cite

Early-onset sepsis in term infants admitted to neonatal intensive care units (2011-2016).

Journal Article J Perinatol · January 2021 OBJECTIVES: Investigate characteristics of term infants culture-evaluated for early-onset sepsis (EOS) in neonatal intensive care units (NICUs), frequencies of organisms causing EOS, and factors associated with EOS. STUDY DESIGN: Using a cohort design, we ... Full text Link to item Cite

An Update on the Prevention and Management of Bronchopulmonary Dysplasia.

Journal Article Pediatric Health Med Ther · 2021 Bronchopulmonary dysplasia (BPD) is a common morbidity affecting preterm infants and is associated with substantial long-term disabilities. There has been no change in the incidence of BPD over the past 20 years, despite improvements in survival and other ... Full text Link to item Cite

Characterization of Death in Infants With Neonatal Seizures.

Journal Article Pediatr Neurol · December 2020 BACKGROUND: Neonatal seizures are associated with death and neurological morbidity; however, little is known about how neonates with seizures die. METHODS: This was a prospective, observational cohort study of neonates with seizures treated at seven sites ... Full text Link to item Cite

Infection control and other stewardship strategies in late onset sepsis, necrotizing enterocolitis, and localized infection in the neonatal intensive care unit.

Journal Article Semin Perinatol · December 2020 Suspected or proven late onset sepsis, necrotizing enterocolitis, urinary tract infections, and ventilator associated pneumonia occurring after the first postnatal days contribute significantly to the total antibiotic exposures in neonatal intensive care u ... Full text Link to item Cite

Exchange transfusion safety and outcomes in neonatal hyperbilirubinemia.

Journal Article J Perinatol · October 2020 OBJECTIVE: To characterize the prevalence of exchange transfusion (ET), clinical characteristics of infants receiving ET, and ET-associated morbidity and mortality. STUDY DESIGN: We conducted a multicenter cohort study of infants ≥23 weeks of gestational a ... Full text Link to item Cite

Outcomes associated with surfactant in more mature and larger premature infants with respiratory distress syndrome.

Journal Article J Perinatol · August 2020 OBJECTIVE: Examine the effect of off-label surfactant on mortality and morbidity in more mature and larger premature infants diagnosed with respiratory distress syndrome (RDS). STUDY DESIGN: Cohort study of premature infants born at 30-36 weeks, birth weig ... Full text Link to item Cite

Paradoxical Antibiotic Effect of Ampicillin: Use of a Population Pharmacokinetic Model to Evaluate a Clinical Correlate of the Eagle Effect in Infants With Bacteremia.

Journal Article Pediatr Infect Dis J · August 2020 BACKGROUND: High doses of ampicillin are often used to achieve therapeutic drug concentrations in infants. A paradoxical antibiotic effect, often called the Eagle effect, occurs when increasing concentrations of antibiotic above a threshold results in decr ... Full text Link to item Cite

Dosing of Antimicrobials in the Neonatal Intensive Care Unit: Does Clinical Practice Reflect Pharmacokinetics-based Recommendations?

Journal Article Pediatr Infect Dis J · August 2020 BACKGROUND: We sought to compare meropenem and fluconazole dosing in the neonatal intensive care unit with recommendations based on published pharmacokinetic (PK) studies in infants. METHODS: We performed an observational cohort study of infants <90 days p ... Full text Link to item Cite

Contemporary trends in global mortality of sepsis among young infants less than 90 days old: protocol for a systematic review and meta-analysis.

Journal Article BMJ Open · July 31, 2020 INTRODUCTION: Neonatal sepsis has a high mortality rate that varies across different populations. We aim to perform a contemporary global evidence synthesis to determine the case fatality rates of neonatal sepsis, in order to better delineate this public h ... Full text Link to item Cite

Probiotic Use and Safety in the Neonatal Intensive Care Unit: A Matched Cohort Study.

Journal Article J Pediatr · July 2020 OBJECTIVE: To determine the prevalence of probiotic administration in infants born preterm over time, as well as the association between probiotic administration and select adverse outcomes. STUDY DESIGN: We performed a multicenter cohort study of infants ... Full text Link to item Cite

Neurocognitive impairment after neonatal sepsis: protocol for a systematic review and meta-analysis.

Journal Article BMJ Open · June 11, 2020 INTRODUCTION: The effect of neonatal sepsis on the developing brain is not well documented. We aim to perform evidence synthesis to determine the outcome of neurodevelopmental impairment and intellectual disability among survivors of neonatal sepsis. The d ... Full text Link to item Cite

Impact of Early-Onset Sepsis and Antibiotic Use on Death or Survival with Neurodevelopmental Impairment at 2 Years of Age among Extremely Preterm Infants.

Journal Article J Pediatr · June 2020 OBJECTIVE: To evaluate the hypothesis that early-onset sepsis increases risk of death or neurodevelopmental impairment (NDI) among preterm infants; and that among infants without early-onset sepsis, prolonged early antibiotics alters risk of death/NDI. STU ... Full text Link to item Cite

Medications and in-hospital outcomes in infants born at 22-24 weeks of gestation.

Journal Article J Perinatol · May 2020 OBJECTIVE: To evaluate the most commonly used medications and in-hospital morbidities and mortality in infants born 22-24 weeks of gestation. STUDY DESIGN: Multicenter retrospective cohort study of infants born 22-24 weeks of gestation (2006-2016), without ... Full text Link to item Cite

Urine gastrin-releasing peptide in the first week correlates with bronchopulmonary dysplasia and post-prematurity respiratory disease.

Journal Article Pediatr Pulmonol · April 2020 RATIONALE: Bronchopulmonary dysplasia (BPD) is associated with post-prematurity respiratory disease (PRD) in survivors of extreme preterm birth. Identifying early biomarkers that correlate with later development of BPD and PRD may provide insights for inte ... Full text Link to item Cite

Authors' Response.

Journal Article Pediatrics · April 1, 2020 Full text Link to item Cite

A Pharmacoepidemiologic Study of the Safety and Effectiveness of Clindamycin in Infants.

Journal Article Pediatr Infect Dis J · March 2020 BACKGROUND: Despite the absence of adequate safety or efficacy data, clindamycin is widely prescribed in the neonatal intensive care unit. We evaluated the association between clindamycin exposure and adverse events, as well as antibiotic effectiveness in ... Full text Link to item Cite

Disparities in the use of antenatal corticosteroids among women with hypertension in North Carolina.

Journal Article J Perinatol · March 2020 OBJECTIVE: To evaluate antenatal corticosteroids (ANS) use in pregnant women with hypertension. STUDY DESIGN: Retrospective analysis of ANS use in the Perinatal Quality Collaborative of North Carolina between 2015 and 2017. RESULTS: Twenty-five centers par ... Full text Link to item Cite

Impact of Gastrostomy Tube Placement on Short-Term Weight Gain in Hospitalized Premature Infants.

Journal Article JPEN J Parenter Enteral Nutr · February 2020 BACKGROUND: Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. METHODS: We compared daily weight changes for ... Full text Link to item Cite

Wide variation in caffeine discontinuation timing in premature infants.

Journal Article J Perinatol · February 2020 OBJECTIVE: To assess site variability and concomitant respiratory support related to the timing of caffeine discontinuation, and compare clinical characteristics of infants who discontinued caffeine before vs. within the last week of hospitalization. STUDY ... Full text Link to item Cite

Association of Adverse Hearing, Growth, and Discharge Age Outcomes With Postnatal Cytomegalovirus Infection in Infants With Very Low Birth Weight.

Journal Article JAMA Pediatr · February 1, 2020 IMPORTANCE: Studies suggest that postnatal cytomegalovirus (CMV) infection can lead to long-term morbidity in infants with very low birth weight (VLBW; <1500 g), including bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and neurodevelopm ... Full text Link to item Cite

Validation and human factor analysis study of an infant weight estimation device.

Journal Article BMC Pediatr · January 22, 2020 BACKGROUND: Weight is critical for the medical management of infants; however, scales can be unavailable or inaccessible in some practice settings. We recently developed and validated a robust infant weight estimation method based on chest circumference (C ... Full text Link to item Cite

Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates.

Journal Article J Perinatol · January 2020 OBJECTIVES: To evaluate the use of sedatives and analgesics during therapeutic hypothermia in encephalopathic neonates and assess associations between medication exposure and hospital outcomes. STUDY DESIGN: We identified neonates ≥35 weeks gestational age ... Full text Link to item Cite

Comparative safety profile of chloral hydrate versus other sedatives for procedural sedation in hospitalized infants.

Journal Article J Neonatal Perinatal Med · 2020 BACKGROUND: Given the limited available evidence on chloral hydrate safety in neonatal populations and the discrepancy in chloral hydrate acceptance between the US and other countries, we sought to clarify the safety profile of chloral hydrate compared to ... Full text Link to item Cite

Pharmacoepidemiology of Furosemide in the Neonatal Intensive Care Unit.

Journal Article Neonatology · 2020 BACKGROUND: Furosemide is commonly used off-label in the neonatal intensive care unit (NICU), but current dosing practices vary widely. OBJECTIVES: To describe dosing practices including route, dose, and duration of exposure to furosemide in a large number ... Full text Link to item Cite

A predictive model for extubation readiness in extremely preterm infants.

Journal Article J Perinatol · December 2019 OBJECTIVE: To develop an estimator for predicting successful extubation for an individual preterm infant. STUDY DESIGN: This was a retrospective study that included infants with birth weights ≤1250 g, who were admitted to a tertiary NICU over a 7-year peri ... Full text Link to item Cite

Dexmedetomidine Pharmacokinetics and a New Dosing Paradigm in Infants Supported With Cardiopulmonary Bypass.

Journal Article Anesth Analg · December 2019 BACKGROUND: Dexmedetomidine is increasingly used off-label in infants and children with cardiac disease during cardiopulmonary bypass (CPB) and in the postoperative period. Despite its frequent use, optimal dosing of dexmedetomidine in the setting of CPB h ... Full text Link to item Cite

Risk of development of treated retinopathy of prematurity in very low birth weight infants.

Journal Article J Perinatol · November 2019 OBJECTIVE: Quantify the risk of treatment for retinopathy of prematurity (ROP) among infants meeting current U.S. screening guidelines. STUDY DESIGN: Among infants ≤1500 g birth weight or ≤30 weeks gestation screened for ROP from 2006-2015, we developed a ... Full text Link to item Cite

Variation in Gastrostomy Tube Placement in Premature Infants in the United States.

Journal Article Am J Perinatol · October 2019 OBJECTIVE: To describe the variation in surgical gastrostomy tube (SGT) placement in premature infants among neonatal intensive care units (NICUs) in the United States. STUDY DESIGN: We identified 8,781 premature infants discharged from 114 NICUs in the Pe ... Full text Link to item Cite

Neurodevelopmental Outcomes of Preterm Infants With Retinopathy of Prematurity by Treatment.

Journal Article Pediatrics · August 2019 OBJECTIVE: Among extremely preterm infants, we evaluated whether bevacizumab therapy compared with surgery for retinopathy of prematurity (ROP) is associated with adverse outcomes in early childhood. METHODS: This study was a retrospective analysis of pros ... Full text Link to item Cite

Prolonged duration of early antibiotic therapy in extremely premature infants.

Journal Article Pediatr Res · June 2019 BACKGROUND: Prolonged early antibiotics in extremely premature infants may have negative effects. We aimed to assess prevalence and outcomes of provision of prolonged early antibiotics to extremely premature infants in the absence of culture-confirmed infe ... Full text Link to item Cite

Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants.

Journal Article J Pediatr · May 2019 OBJECTIVE: To evaluate the association between furosemide exposure and risk of bronchopulmonary dysplasia (BPD). STUDY DESIGN: This retrospective cohort study included infants (2004-2015) born at 23-29 weeks gestational age and 501-1249 g birth weight. We ... Full text Link to item Cite

The Association of Hydrocortisone Dosage on Mortality in Infants Born Extremely Premature.

Journal Article J Pediatr · April 2019 OBJECTIVE: To characterize common dosing strategies and to investigate the association between hydrocortisone dosage and in-hospital mortality in infants born extremely premature. STUDY DESIGN: We performed a retrospective review of a cohort of infants bor ... Full text Link to item Cite

When to Include a Lumbar Puncture in the Evaluation for Neonatal Sepsis.

Journal Article Neoreviews · March 2019 Meningitis is a devastating infection in infants and is linked to adverse long-term outcomes. The prevalence of meningitis is variable and depends on gestational age, postnatal age, and clinical setting. Early diagnosis and treatment with appropriate antib ... Full text Link to item Cite

Safety, Effectiveness and Exposure-response of Micafungin in Infants: Application of an Established Pharmacokinetics Model to Electronic Health Records.

Journal Article Pediatr Infect Dis J · February 2019 Micafungin is used off-label in the United States to treat invasive candidiasis in neonates. We used an established pharmacokinetic model to determine micafungin exposures for 46 courses in 39 hospitalized infants. In this small cohort of infants, micafung ... Full text Link to item Cite

Intranasal midazolam and fentanyl for procedural sedation and analgesia in infants in the neonatal intensive care unit.

Journal Article J Neonatal Perinatal Med · 2019 BACKGROUND: The intranasal route is a minimally invasive method for rapidly delivering midazolam and fentanyl to provide short-term analgesia and sedation in infants. However, intranasal use of midazolam and fentanyl is not labeled for infants and safety d ... Full text Link to item Cite

National Survey of Neonatal Intensive Care Unit Medication Safety Practices.

Journal Article Am J Perinatol · December 2018 OBJECTIVE: We conducted a detailed survey to identify medication safety practices among a large network of United States neonatal intensive care units (NICUs). METHODS: We created a 53-question survey to assess 300 U.S. NICU's demographics, medication safe ... Full text Link to item Cite

Morphine vs Methadone Treatment for Infants with Neonatal Abstinence Syndrome.

Journal Article J Pediatr · December 2018 OBJECTIVE: To estimate the relationship of initial pharmacotherapy with methadone or morphine and length of stay (LOS) in infants with neonatal abstinence syndrome (NAS) admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: From the Pediatrix ... Full text Link to item Cite

Association of Atrial Septal Defects and Bronchopulmonary Dysplasia in Premature Infants.

Journal Article J Pediatr · November 2018 OBJECTIVE: To evaluate the association between the presence of an atrial septal defect (ASD) and the odds of developing bronchopulmonary dysplasia (BPD) in premature infants. STUDY DESIGN: We identified a cohort of infants that underwent at least one echoc ... Full text Link to item Cite

Predictors of Prolonged Breast Milk Provision to Very Low Birth Weight Infants.

Journal Article J Pediatr · November 2018 OBJECTIVE: To identify factors associated with prolonged maternal breast milk (BM) provision in very low birth weight (VLBW) infants. STUDY DESIGN: This was a cohort study of VLBW infants who initially received maternal BM and were born at one of 197 neona ... Full text Link to item Cite

Prevalence and safety of diazoxide in the neonatal intensive care unit.

Journal Article J Perinatol · November 2018 OBJECTIVE: Diazoxide is used to treat infants with persistent hypoglycemia, but the prevalence of its use and adverse effects are not well described. We report demographic and clinical characteristics of infants treated with diazoxide in neonatal intensive ... Full text Link to item Cite

Racial/ethnic differences in necrotizing enterocolitis incidence and outcomes in premature very low birth weight infants.

Journal Article J Perinatol · October 2018 BACKGROUND: As advances in neonatal intensive care increase the survival of extremely premature infants, the at-risk population for necrotizing enterocolitis (NEC) continues to rise. Although racial health disparities in preterm births have been well docum ... Full text Link to item Cite

Prolonged furosemide exposure and risk of abnormal newborn hearing screen in premature infants.

Journal Article Early Hum Dev · October 2018 BACKGROUND: At very high doses, furosemide is linked to ototoxicity in adults, but little is known about the risk of hearing loss in premature infants exposed to furosemide. AIMS: Evaluate the association between prolonged furosemide exposure and abnormal ... Full text Link to item Cite

Association between Furosemide Exposure and Patent Ductus Arteriosus in Hospitalized Infants of Very Low Birth Weight.

Journal Article The Journal of pediatrics · August 2018 ObjectiveTo evaluate the association between furosemide exposure and patent ductus arteriosus (PDA) in a large, contemporary cohort of hospitalized infants with very low birth weight (VLBW).Study designUsing the Pediatrix Medical Group Cl ... Full text Cite

A multi-institution analysis of predictors of timing of inguinal hernia repair among premature infants.

Journal Article J Pediatr Surg · April 2018 PURPOSE: Inguinal hernias are common in premature infants, but there is substantial variation with regards to timing of repair. We sought to quantify and explain this variation. METHODS: Cohort study of infants <34weeks gestation diagnosed with an inguinal ... Full text Link to item Cite

Parents' perceived obstacles to pediatric clinical trial participation: Findings from the clinical trials transformation initiative.

Journal Article Contemp Clin Trials Commun · March 2018 Enrollment of children into pediatric clinical trials remains challenging. More effective strategies to improve recruitment of children into trials are needed. This study used in-depth qualitative interviews with parents who were approached to enroll their ... Full text Link to item Cite

Perceived barriers to pediatrician and family practitioner participation in pediatric clinical trials: Findings from the Clinical Trials Transformation Initiative.

Journal Article Contemp Clin Trials Commun · March 2018 Despite legislation to stimulate pediatric drug development through clinical trials, enrolling children in trials continues to be challenging. Non-investigator (those who have never served as a clinical trial investigator) providers are essential to recrui ... Full text Link to item Cite

Early lumbar puncture and risk of intraventricular hemorrhage in very low birth weight infants.

Journal Article Early Hum Dev · February 2018 BACKGROUND: Lumbar puncture (LP) is the gold standard for diagnosing meningitis; however it is unknown whether early LP (≤3days of life) is associated with increased risk of intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. OBJECTI ... Full text Link to item Cite

Effects of Methadone on Corrected Q-T Interval Prolongation in Critically Ill Children.

Journal Article J Pediatr Pharmacol Ther · 2018 OBJECTIVES: This study aimed to determine the association between methadone use and corrected Q-T interval (QTc) prolongation in critically ill children. METHODS: A retrospective cohort study of critically ill children receiving methadone at a tertiary car ... Full text Link to item Cite

When to Perform Lumbar Puncture in Infants at Risk for Meningitis in the Neonatal Intensive Care Unit

Chapter · January 1, 2018 Meningitis occurs most commonly in the neonatal period and is associated with significant morbidity and mortality. Examination of the cerebrospinal fluid is essential for diagnosis, identification of pathogens, and appropriate choice of therapy. However, t ... Full text Cite

In-Hospital Outcomes Following Extracorporeal Membrane Oxygenation in a Retrospective Cohort of Infants.

Journal Article Am J Perinatol · November 2017 OBJECTIVE: We sought to characterize associations between infant characteristics and extracorporeal membrane oxygenation (ECMO) survival using electronic health records data. STUDY DESIGN: We examined a cohort study of infants ≥32 weeks of gestational age ... Full text Link to item Cite

Association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants.

Journal Article Cardiol Young · November 2017 BACKGROUND: In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of adminis ... Full text Link to item Cite

Population Pharmacokinetics of Dexmedetomidine in Infants.

Journal Article J Clin Pharmacol · September 2017 Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of ... Full text Link to item Cite

Dosing antibiotics in neonates: review of the pharmacokinetic data.

Journal Article Future Microbiol · September 2017 Antibiotics are often used in neonates despite the absence of relevant dosing information in drug labels. For neonatal dosing, clinicians must extrapolate data from studies for adults and older children, who have strikingly different physiologies. As a res ... Full text Link to item Cite

Late-onset Sepsis in Extremely Premature Infants: 2000-2011.

Journal Article Pediatr Infect Dis J · August 2017 BACKGROUND: Late-onset sepsis (LOS) is an important cause of death and neurodevelopmental impairment in premature infants. The purpose of this study was to assess overall incidence of LOS, distribution of LOS-causative organisms and center variation in inc ... Full text Link to item Cite

Antihypertensive drug exposure in premature infants from 1997 to 2013.

Journal Article Cardiol Young · July 2017 BACKGROUND: Systemic hypertension is increasingly recognised in premature infants. There is limited evidence regarding treatment, and most published treatment recommendations are based solely on expert opinions. METHODS: We identified all infants born ⩽32 ... Full text Link to item Cite

Timing of Multiorgan Dysfunction among Hospitalized Infants with Fatal Fulminant Sepsis.

Journal Article Am J Perinatol · June 2017 Objective Identify the progression of specific signs of multiorgan dysfunction among infants with fatal sepsis. Study Design Cohort study of 679 infants who died within 3 days of the start of a late-onset sepsis (LOS) episode in neonatal intensive care uni ... Full text Link to item Cite

Respiratory Support for Very Low Birth Weight Infants Receiving Dexamethasone.

Journal Article J Pediatr · April 2017 OBJECTIVE: To assess how neonatal intensive care units followed the American Academy of Pediatrics guidelines for use of dexamethasone in preterm infants by evaluating respiratory support at the time of dexamethasone administration. STUDY DESIGN: This is a ... Full text Link to item Cite

Risk factors for group B streptococcal disease in neonates of mothers with negative antenatal testing.

Journal Article J Perinatol · February 2017 OBJECTIVE: The aim of this study was to identify risk factors for early-onset group B Streptococcus (EOGBS) disease in neonates of mothers with negative antenatal screening. STUDY DESIGN: We performed a retrospective cohort study of neonates born to mother ... Full text Link to item Cite

Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth outcomes.

Journal Article Early Hum Dev · December 2016 BACKGROUND: Gastrostomy tube (G-tube) placement is a common intervention for newborns with severe feeding difficulties. Infants with congenital diaphragmatic hernia (CDH) are at high risk for feeding problems. Prevalence of G-tube placement and consequent ... Full text Link to item Cite

Use of Therapeutic Drug Monitoring, Electronic Health Record Data, and Pharmacokinetic Modeling to Determine the Therapeutic Index of Phenytoin and Lamotrigine.

Journal Article Ther Drug Monit · December 2016 BACKGROUND: Defining a drug's therapeutic index (TI) is important for patient safety and regulating the development of generic drugs. For many drugs, the TI is unknown. A systematic approach was developed to characterize the TI of a drug using therapeutic ... Full text Link to item Cite

Therapeutic Drug Monitoring, Electronic Health Records, and Pharmacokinetic Modeling to Evaluate Sirolimus Drug Exposure-Response Relationships in Renal Transplant Patients.

Journal Article Ther Drug Monit · October 2016 BACKGROUND: Sirolimus, an immunosuppressive agent used in renal transplantation, can prevent allograft rejection. Identification of the therapeutic index (the ratio of minimum toxic concentration to minimum therapeutic concentration) for immunosuppresants ... Full text Link to item Cite

Therapeutic Index Estimation of Antiepileptic Drugs: A Systematic Literature Review Approach.

Journal Article Clin Neuropharmacol · 2016 OBJECTIVES: Our study aimed to determine whether data obtained from the medical literature can be used to estimate the therapeutic index of 5 antiepileptic drugs (AEDs): carbamazepine, lamotrigine, phenobarbital, phenytoin, and valproate. METHODS: We perfo ... Full text Link to item Cite

Effect of Catheter Dwell Time on Risk of Central Line-Associated Bloodstream Infection in Infants.

Journal Article Pediatrics · December 2015 BACKGROUND AND OBJECTIVE: Central venous catheters in the NICU are associated with significant morbidity and mortality because of the risk of central line-associated bloodstream infections (CLABSIs). The purpose of this study was to determine the effect of ... Full text Link to item Cite

Neonatal candidiasis: diagnosis, prevention, and treatment.

Journal Article J Infect · November 2014 Infection with Candida species is associated with significant morbidity and mortality in infants. The incidence of Candida infection varies widely across centers, likely due to differences in practice related to modifiable risk factors such as exposure to ... Full text Link to item Cite

Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis.

Journal Article J Pediatr · August 2012 OBJECTIVE: To assess the impact of empiric antifungal therapy for invasive candidiasis on subsequent outcomes in premature infants. STUDY DESIGN: This was a cohort study of infants with a birth weight ≤ 1000 g receiving care at Neonatal Research Network si ... Full text Link to item Cite

Repeat lumbar punctures in infants with meningitis in the neonatal intensive care unit.

Journal Article J Perinatol · June 2011 OBJECTIVE: The purpose of this study is to examine the results of repeat lumbar puncture in infants with initial positive cerebrospinal fluid (CSF) cultures in order to determine the clinical characteristics and outcomes of infants with repeat positive cul ... Full text Link to item Cite

Vasopressin for refractory hypotension in extremely low birth weight infants.

Journal Article J Pediatr · September 2010 Intravenous vasopressin at 0.01 to 0.04 units/kg/h increased median mean blood pressure from 26 mm Hg (range 18-44) to 41 mm Hg (range 17-90) by 12 hours of infusion (P=.002) and allowed weaning of catecholamines in a group of extremely low birth weight in ... Full text Link to item Cite

Outcomes of catheter-associated infections in pediatric patients with short bowel syndrome.

Journal Article J Pediatr Gastroenterol Nutr · April 2010 Children with short bowel syndrome requiring long-term total parenteral nutrition are at high risk for catheter-associated infections. The optimal management of catheter infections in this patient population is unknown. We conducted a retrospective observa ... Full text Link to item Cite

Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count.

Journal Article Pediatr Infect Dis J · December 2008 BACKGROUND: Cerebrospinal fluid (CSF) findings are often used to diagnose meningitis in neonates given antibiotics before the lumbar puncture is performed. Traumatic lumbar punctures are common and complicate interpretation of CSF white blood cell counts. ... Full text Link to item Cite