Clinical Associate Professor, Pediatrics - Neonatal and Developmental Medicine
Residency:University of Alabama at BirminghamAL
Internship:University of Alabama at BirminghamAL
Medical Education:Georgetown University School of MedicineDC
Fellowship:Georgetown University HospitalDC
Board Certification: Neonatology, American Board of Pediatrics (2014)
Board Certification: Pediatrics, American Board of Pediatrics (2001)
Effect of reading to preterm infants on measures of cardiorespiratory stability in the neonatal intensive care unit.
Journal of perinatology : official journal of the California Perinatal Association
OBJECTIVE: To evaluate the impact of parental bedside reading (PR) on cardio-respiratory (CR) stability of preterm infants.METHODS/STUDY DESIGN: Prospective examination of the impact of PR on CR stability in preterm NICU infants. CR data from 3 time points: pre-reading (3 and 1h before reading), during PR, and post-reading (1h after reading) were compared.RESULTS: Eighteen infants born at 23-31wks gestation, and 8 to 56 days old, were enrolled. Episodes of oxygen desaturation to <85% were fewer during PR as compared to the pre-reading periods and were fewer with live and maternal PR.CONCLUSION: Preterm infants showed fewer desaturation events less than 85% during PR than prior to reading exposure. This effect persisted up to 1h after reading exposure. Desaturation events were fewer with live and maternal PR. Voice exposure can be an important way for parents to participate in the care of their preterm infants.
View details for PubMedID 30120423
Premature Infants Conceived with Assisted Reproductive Technology: An Analysis of Infant Morbidity, Compared with Infants Conceived Naturally.
American journal of perinatology
OBJECTIVE: This article evaluates the morbidity of infants born via assisted reproductive technology (ART) compared with matched naturally conceived infants.STUDY DESIGN: This is a retrospective review of maternal and infant data among inborn infants conceived via ART and matched control infants born at 30 to 34 weeks' gestational age (GA) between 2006 and 2012. Data were analyzed using paired t-test or Wilcoxo-Mann-Whitney test for continuous and Fisher's exact test for categorical variables. p-Value of<0.05 was considered significant.RESULT: Of 120 study infants, 60 were conceived via ART and 60 naturally. Control infants were matched for GA, gender, race, and multiple gestations. ART infants required more respiratory support and took longer to reach full feeds compared with control infants.CONCLUSION: Infants born via ART are physiologically more immature with more intensive care needs than naturally conceived infants of similar gestation, potentially increasing health care costs. This immaturity should be considered when planning early delivery in these pregnancies.
View details for PubMedID 30064149
Pilot study of dornase alfa (Pulmozyme) therapy for acquired ventilator-associated infection in preterm infants.
Evaluate the feasibility, safety, and efficacy of adjunctive treatment with dornase alfa in preterm patients with ventilator-associated pulmonary infection (VAPI) compared to standard care.We hypothesize that therapy with dornase alfa will be safe and well tolerated in the preterm population with no worsening of symptoms, oxygen requirement, or need for respiratory support.Prospective, randomized, blinded, pilot study comparing adjunctive treatment with dornase alfa to sham therapy. In addition to standard care, infants were randomized to receive dornase alfa 2.5 mg nebulized via endotracheal tube (ETT) every 12 hr for 7 days or sham therapy. ETT secretion gram stain and culture and chest X-ray (CXR) findings were evaluated. Respiratory support data were downloaded from the ventilator.Fourteen infants developed VAPI between 2012 and 2014; 11 enrolled in the study. Six received dornase alfa and five received sham therapy. Average gestational age at birth was 25 weeks and age at study entry was 31 days. There were no differences in demographics, ETT white blood cell count (WBC), CXR, or mean airway pressure (MAP) between the two groups. There was a trend towards decreased oxygen requirement (FiO2) in the treatment group that did not reach statistical significance. No side effects were observed in the treatment group.Treatment with dornase alfa is safe and treated infants had some improvement in FiO2 requirement but no improvement in MAP. A larger randomized trial is needed to evaluate the efficacy of this therapy. Pediatr Pulmonol. 2016; 9999:XX-XX. © 2016 Wiley Periodicals, Inc.
View details for DOI 10.1002/ppul.23656
View details for PubMedID 28052587