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Department of Pediatrics

Neonatology

Overview
Overview

We will improve the neonatal outcomes by:

  1. Providing outstanding evidence-based neonatal clinical care
  2. Advancing neonatal scholarship
  3. Educating the next generation of neonatal caregivers

History of Division Leadership and Research Focus:

The Division of Neonatal Biology and Respiratory Diseases of the Department of Pediatrics at the University of Washington was officially created in 1963 with the recruitment of Dr. Tim Oliver. He then recruited Dr. W. Alan Hodson from Johns Hopkins in 1966 as a second faculty member. A third faculty member, Dr. Dick Wennberg, was added in 1969 and a fourth, Dr. David Woodrum, in 1971. Dr. Oliver left Seattle in 1971 to become Chair of Pediatrics at Pittsburgh and Dr. Hodson became head of the Division.

Between 1966 and 1970, research funding for the Division was obtained from the NICHD with a Neonatal Biology Training Grant, an individual research award, and a satellite clinical research center. In 1972, Division members worked together with members of the Department of Medicine to obtain a 5‐year Specialized Center of Research (SCOR) Grant in respiratory disease from the NHLBI. This SCOR became an independent pediatric pulmonary SCOR when it was renewed in 1976, with a second 5‐year renewal in 1982. In 1987, a Program Project grant entitled “Pathophysiology of Respiratory Disorders of the Newborn” was funded through the NHLBI for a 5‐year period ending in 1992. In 1997, Pediatric Pulmonary Medicine officially became its own division under the direction of Dr. Greg Redding.

Dr. Christine Gleason was recruited from Johns Hopkins as Division Head of Neonatology in 1997 and she led the division in developmental neuroscience. In 2000, Dr. Sandra Juul was recruited, and her NIH‐ funded bench research programs focused on neurodevelopment and neonatal neuroprotection, with translation to multicenter clinical trials of erythropoietin (Epo) neuroprotection. The addition of senior scientist Dr. Colin Studholme to the Division in 2011 brought state of the art neuroimaging techniques for fetal and neonatal brain imaging. In 2013, Dr. Juul was awarded a $10.1 million UO1 grant supporting a 5‐year multi‐center clinical trial investigating Epo as a neuroprotective agent in extremely preterm infants, and in 2016 a second U01 grant was awarded to study the neuroprotective effects of Epo for term infants with hypoxic ischemic encephalopathy. Dr. Juul became division head in January 2015. As the Division has grown, so has our sphere of research interests, and these now include global neonatal‐perinatal health, health professional simulation, pulmonary physiology and ethics.

The Division received $600,000 in research funds during the academic year. Our division neonatologists currently staff two (2) level IV NICUs (88 beds) and three (3) level III NICUs (87 beds). Our APPs and neonatal hospitalist faculty staff five (5) level II NICUs (24 beds) with oversight and medical direction provided by our neonatologists, for a total of ten (10) sites and 199 NICU beds.

Faculty Demographics

 

Faculty Scientist

Clinician Scholar

Full-time Clinical

Total

 

Professor

1

6

7

14

42%

Associate Professor

0

5

4

9

25%

Assistant Professor

1

8

3

12

31%

Acting Assistant Professor

 0

0

 0

0

3%

Total

2

19

14

35

 
 

6%

54%

40%

 

100%

 

*FTE normalized to 100%

Research Faculty

Physician-Scientists and Clinical Scholars

Full-time Clinical

Scholarship & Research

97%

26%

10%

Administrative Leadership

4%

18%

4%

Medical Leadership

0%

6%

19%

Clinical

0%

51%

67%

  101%

101%

100%

 

74% White, 11% Asian, 9% Hispanic, 6% Black, and 6% Multiracial/Multiethnic
80% Heterosexual, 3% Gay, 3% Lesbian, 3% Pansexual
74% Full-time, 26% Part-time
34% Children over 18, 49% One or more under 18, and 20% No Children
34% No pets, 51% Live with dogs, 23% Live with cats, 6% Have a horse and 11% Other pets  
63% Enjoy hiking, 46% Enjoy cooking, 31% Enjoy skiing

At the University of Washington, diversity is integral to excellence. We value and honor diverse experiences and perspectives, strive to create welcoming and respectful learning environments, and promote access, opportunity, and justice for all.

Clinical Programs
Clinical Programs

Neonatal Intensive Care Units

University of Washington Medical Center-Montlake Neonatal Intensive Care Unit (Level IV):

Thomas P. Strandjord, MD, Medical Director
Tiffany Stanley, ARNP,, NNP Program Manager

The UWMC NICU admits critically ill newborns from one of the highest risk obstetric services in the nation. The multi‐professional perinatal and NICU teams have special expertise in management of the most fragile growth‐restricted and extremely premature fetuses and newborns. The high‐risk perinatal program receives obstetrics referrals from throughout the WWAMI region for fetal abnormalities, severe maternal illness, and extreme prematurity and is the site of delivery for the most complex birth defects, including infants requiring EXIT procedures for airway anomalies. Additional advanced services include therapeutic hypothermia and the full range of ventilation strategies including inhaled nitric oxide, high –frequency oscillatory and jet ventilation. The NICU medical team includes neonatal faculty, neonatal fellows, neonatal nurse practitioners, neonatal hospitalists, pediatric residents, interns and medical students. The inter‐professional team includes dedicated respiratory therapists, neonatal pharmacists, dieticians, physical therapists, speech language pathologists and social work support. The nursing team includes three tiers of RN expertise and leadership. A state‐of‐the‐art 50‐bed NICU opened October 2012. The NICU includes 42 single‐bed rooms with space for a family member to stay with their infant plus several additional rooms for multiples as well as an integrated OR for surgical procedures. Patients are cared for by one of two multi‐disciplinary teams, a resident‐based team, and an NNP/hospitalist team. The UWMC NICU’s care model includes 24/7 coverage by in‐house residents and, mid‐level intensivists (fellow or NNP/PA), under the direction of attending neonatologists. In 2020, the UWMC had 1961 deliveries with 469 NICU admissions. The average daily census was 28 with 17 preterm infants weighing less than 1500 grams at birth and an average daily census of 1.6 on ventilators.

Seattle Children’s Hospital Neonatal Intensive Care Unit (Level IV):

Robert DiGeronimo, MD, Medical Director
Zeenia Billimoria, MD, Assoc. Medical Director
April Morris, MN, ARNP, Manager, Advance Practice Services
Melissa Koll, MN, ARNP, Supervisor of SCH NICU APPs

The Neonatal Intensive Care Unit at Seattle Children’s Hospital is the highest rated Level IV NICU in the Seattle area and serves as the major quaternary referral center for medically and surgically complex neonates in the Pacific Northwest. Seattle Children’s NICU admits 500 patients annually and has over 500 affiliated faculty that represent all pediatric subspecialties including– more than any other hospital in the region. The Children’s NICU provides the full spectrum of neonatal medical care including therapeutic hypothermia for acute hypoxic ischemic encephalopathy, seizures, high frequency ventilation, inhaled nitric oxide and ECMO for severe respiratory failure, renal replacement therapy including dialysis and surgical expertise in the areas of congenital diaphragmatic hernia, intestinal failure, bowel atresia, craniofacial anomalies, reconstructive pelvic medicine, post‐hemorrhagic hydrocephalus, neural tube defects and neurovascular malformations. In addition, we offer multidisciplinary care teams providing neuro‐critical care, congenital diaphragmatic hernia and management of bronchopulmonary dysplasia.

Daily rounds with the medical team incorporate the patient’s family, NICU nurses, dieticians, pharmacists and respiratory therapists. The NICU team accepts admissions of critically ill neonates up to 44 weeks’ post menstrual age from the 5‐state WAMI region. The Seattle Children’s Hospital NICU’s care model includes an in‐house fellow or NNP and attending neonatologist 24/7. Seattle Children's Prenatal Diagnosis and Treatment Program partners with the University of Washington to provide care for pregnant women and their families when pregnancy is complicated by known or suspected conditions in the developing fetus. Our program integrates obstetric, neonatology and pediatric specialty care for families facing complicated pregnancy management or decision‐making. Seattle Children’s NICU participates in research and quality improvement initiatives via its active participation in a number of national and/or international collaborative associations including the Children’s Hospital Neonatal Consortium, Congenital Diaphragmatic Hernia Study Group, Bronchopulmonary Dysplasia Collaborative and the Extracorporeal Life Support Organization.

UW Medicine/Valley Medical Center Neonatal Intensive Care Unit (Level III)

Christina Long, DO, Medical Director
Toby Cohen, MD, Assoc. Medical Director
Carol Otto MSN, ARNP, Supervisor, Valley Medical Center

In July 2017, Neonatologists and Advanced Neonatal Practitioners from University of Washington/Seattle Children’s Hospital began a collaborative effort to staff the NICU at UW/Valley Medical Center. The unit has a 29‐bed capacity. The single‐bed rooms provide space and privacy for our patients and their families. Two, unique, infant stabilization rooms allow immediate resuscitation of infants in the NICU after birth without requiring transport after stabilization. Valley has a robust high‐ risk perinatal clinic and the Neonatologists work closely in conjunction with the high‐risk team to provide consults for families prenatally. The Valley NICU uses a multi‐disciplinary approach to patient care with NICU dedicated pharmacists, dieticians, physical therapists, speech therapists, respiratory therapists, social work, and NICU nurses. This multi‐disciplinary staff meets with families to provide the best family‐centered care for our patients. Advanced services provided at Valley include therapeutic hypothermia with 24/7 Pediatric Neurology support and a large range of ventilation strategies including high‐frequency oscillatory ventilation. Advanced Neonatal Practitioners staff the NICU with 24/7 in‐ house coverage under the direction of attending Neonatologists. In AY 2018, Valley had 3474 number of deliveries with 212 NICU admissions.

Providence Regional Medical Center Everett Neonatal Intensive Care Unit (Level III):

Michael D. Neufeld, MD, MPH, Medical Director
Anna Hedstrom MD, Assoc. Medical Director
Maya Kaneyasu, BSN, MN, ARNP Supervisor, Providence Regional Medical Center Everett

Providence Regional Medical Center Everett’s 29‐bed capacity NICU opened on Mother’s Day in 2002. The unit was developed through the efforts of an alliance between PRMCE and Seattle Children’s Hospital. Individual rooms provide privacy for patients and their families. The multidisciplinary team meets daily with parents and concentrates on family‐centered care, teaching parents how to take care of their infants, especially those with special needs. In preparation for discharge, parents are provided in‐depth instruction on how to manage emergencies that may arise in the home, including the need for CPR. The unit cares for infants of all gestational ages and has HFJV, HFOV, and iNO in addition to conventional ventilation. The care model at PRMCE is 24/7 in‐house Advanced Neonatal Practitioners and Physician Assistants under the direction of an attending neonatologist. In AY 2020, PRMCE had 4162 deliveries with 588 NICU admissions. The average daily census was 23.5 with 59 preterm infants weighing less than 1500 grams at birth.

 

Franciscan Health Care System; St Joseph Medical Center (Level III); St Francis Hospital (Level II); St Michael Medical Center (Level II); St Anne Hospital (Level II):

Stephen Welty, MD, Medical Director
Robin LaGrandeur, MD, Associate Medical Director
Meenakshi Dutta MD, St Anne Medical Director
Justine Wood, ARNP, NNP‐BC, Supervisor, CHI‐Franciscan Health System

Franciscan Health Care System includes a network of hospitals with approximately 9,000 deliveries annually at its 5 obstetrical facilities: St Joseph Medical Center in Tacoma, St Francis Hospital in Federal Way, St Elizabeth Hospital in Enumclaw, St Michael Medical Center in Silverdale, and St Anne Hospital in Burien. St Joseph Medical Center has a licensed capacity of 34 neonatal beds and has 24/7 in‐house Advanced Neonatal Practitioners supported by faculty neonatologists. St. Francis Hospital has a licensed capacity of 10 Level II beds that receive medical care from local pediatricians, with consultation and attendance at high‐risk deliveries as needed from SCH Advanced Neonatal Practitioners and/or neonatologists. For 12 hours/day, Saint Francis has in house coverage with the Advanced Neonatal Practitioners with support from Neonatology Providers and for the other 12 hours/day, Neonatology provides coverage directly and via telemedicine. St Anne Hospital has a licensed capacity of 5 Level II beds, with inpatient Level II care and consultative services provided by Seattle Children’s Neonatologists on call. St. Elizabeth is a critical access hospital with 345 deliveries a year. Seattle Children’s Hospital partnered with the Franciscan Health Care System to begin providing Neonatology services and medical direction on April 1, 2013, and St. Joseph Medical Center opened its new Level III NICU in June 2013, and St Anne Hospital began its collaboration with Seattle Children’s in November 2018. This partnership has made it possible for the vast majority of patients to stay within their community while receiving excellent care for their fragile newborns. On 1/22/18, we lowered the gestational age at which we would manage patients at SJMC to 25 weeks as our threshold of care at SJMC. With the continued emphasis on non‐invasive ventilation as our primary mode of respiratory support, we average between 4 and 6 babies on nasal CPAP per day and less than one baby per day on invasive ventilatory support. In September of 2018, we expanded our care to provide inhaled nitric oxide for infants with hypoxic respiratory failure and we utilized it on three patients with excellent clinical responses. In AY 2018, St. Joseph’s had approximately 4100 deliveries with 480 NICU admissions. Our average daily census was 17.0 with 44 premature infants weighing less than 1500 and 14 weighing less than 1000 grams at birth.

University of Washington Medical Center - Northwest Neonatal Intensive Care Unit (Level II):

Angel Rios, MD, Pediatric Section Head
Thomas P. Strandjord, MD, Assoc. Medical Director

In November of 2018 Northwest Hospital Special Care Nursery, a Level II NICU began a collaborative effort with the UW Division of Neonatology and Seattle Children’s Hospital to support care for infants born prematurely at greater than 32 weeks, as well as term infants who may be suffering from a variety of neonatal conditions including but not limited to breathing difficulties and infections. Northwest Hospital delivery service sees approximately 1100 newborn infants annually. Although historically the service delivers primarily low risk patients there is always the potential need for the expertise provided by 24/7 in house coverage by our team of Advanced Neonatal Practitioners who have immediate access to consultation with UW/SCH neonatologists and a premier critical care neonatal transport system. The unit is being remodeled to support the focus on family centered care with increased opportunity and available space for couplet care.

 

Swedish Issaquah Hospital Neonatal Intensive Care Unit (Level II):

Jose Perez, MD, MBA, Medical Director
Christine Cooper, DNP, ARNP, Supervisor

In April of 2019, Swedish Issaquah Hospital began a collaborative partnership with Seattle Children’s Hospital to staff their 15 bed Level II NICU with 24/7 neonatal APPs from SCH. This new and beautiful unit offers single‐patient care rooms that promote family‐centered care. With input as needed from the on‐call neonatologist at SCH, they manage patients in the NICU down to 32 weeks’ gestation and admit and discharge normal newborns. During the first year, they cared for 750 patients, about 25‐30% of whom were in the NICU. The APPs use a mobile telemedicine platform to include the resource neonatologist at SCH in interdisciplinary bedside rounds each morning with the patient’s family, nurse, dietician, pharmacist, respiratory therapist, and other providers as needed, such as feeding specialist, physical therapist, and social worker. On‐site consultations are available from pediatric cardiologists, otolaryngologists, and nephrologists.

Neonatal Consultation and Transport Program

Robert DiGeronimo, MD, Medical Director; Christopher Baker, MSN, MBA, RN C-NPT, Clinical Manager

The Division provides 24/7 neonatal consultation services for the 5-state WWAMI region.  Neonatal transport services for Seattle Children’s and its affiliated hospital partners is provided by dedicated teams from Seattle Children’s and Airlift Northwest. Our transport team are leaders in safe newborn transport and have ground, rotor and fixed wing capability. Teams are comprised of specially trained transport nurses and respiratory therapists. Infants from referral centers throughout the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region are transported to Seattle Children’s. Services provided include various modes of non-invasive support, high frequency ventilation, administration of nitric oxide, blood gas analysis and mobile extracorporeal membrane oxygenation for critically ill patients too unstable to move via conventional support.

Telemedicine Program

Rachel Umoren MBBCh, MS, Neonatal Telemedicine Lead, Inpatient Medical Director for Telehealth; Ujiro Okiomah MBA, Program Manager

Core Team: Chris Cooper, Craig Jackson, Megan Gray, Taylor Sawyer

Since 2019, a dedicated neonatal telehealth team staffed by trained neonatologists and advanced practice providers has provided neonatal teleconsultation services including telerounding, teleconsultation and teleresuscitation.

Prenatal Diagnosis Programs

Prenatal Diagnosis and Treatment Program at Seattle Children’s Hospital

Craig Jackson, MD, MHA; Robert DiGeronimo, MD, and Zeenia Billimoria, MD

This multidisciplinary clinic is held Monday through Friday in the Springbrook office center which is across the street from the main hospital. Patients are referred from Washington,  Alaska,  Montana,  and Idaho. More than 1000 patients are seen annually for fetal imaging with ultrasound, echocardiogram, and MRI, and for multidisciplinary counseling by our UW maternal‐fetal medicine specialists, pediatric medical and surgical specialists, prenatal nurses, and by our genetic counselor and prenatal social worker. About half of the visits are for fetal cardiac evaluation for known or suspected fetal cardiac defects such as ductal‐dependent cyanotic heart disease, fetal arrhythmias, or for maternal health risk factors for fetal congenital heart disease. The remainder are referred for suspected fetal surgical problems (e.g., congenital diaphragmatic hernia, congenital pulmonary airway malformations, gastroschisis), neurodevelopmental disorders (e.g., open neural tube defects, ventriculomegaly), renal or urologic problems (e.g., urinary tract obstruction, renal dysplasia), and genetic issues (e.g., trisomy 13, 18, and 21 and numerous specific genetic conditions). Neonatologists are asked to join the multidisciplinary counseling for patients with fetal conditions that are complex, likely to require advanced delivery room resuscitation or admission to SCH, or which raise the possibility of offering palliative care. Research projects during 2020 included the following:

Principle Investigator

Project Title

Bhawna Arya

Fetal anatomy and physiology and associations with fetal and perinatal outcomes in DTGA/IVS: a collaborative, multicenter, multi-arm prospective study

Hannah Tully, Dan Doherty

“Retrospective Review of Prenatally Diagnosed Fetal Central Nervous System Abnormalities”

Aarti Bhat

Prenatal detection of HLHS and dTGA: significant socioeconomic and geographic barriers

Kiana Siefkas

Biallelic SCN5A Variants Cause Prenatal Onset of Complex Cardiac Arrhythmias

Bhawna Arya, Kim Riehle

Utility of maternal hyperoxygenation testing in predicting outcomes in fetuses at risk for developing PPHN

Bhawna Arya

Prenatal predictors of coarctation of the aorta

Bhawna Arya, Mikki Clouse

Cerebral Doppler pattern in coarctation of the aorta

Bhawna Arya

Fetal predictors of PAIVS outcomes

Bhawna Arya

Fetal predictors of mitral valve dysplasia outcomes

Bhawna Arya

Umbrella IRB for fetal CHD retrospective studies

Ian Glass

Donation of Embryonic & Fetal Tissue for Research (BDRL)

Daniel Doherty

NDV Disorders & Hindbrain Malformations

Colin Studholme

Fetal Imaging/MRI Brain Development

William Walker

Evaluation of the Best Urologic Management for Newborns and Young Children with Spina Bifida

Elizabeth Caris

Resiliency in Families affected by Congenital Heart Disease

Bailey Brinks

Prenatal Tour Study: Evaluating Newborn Hospitalization Preparedness In Families With Prenatal Diagnosis

 

Prenatal Diagnosis Program at University of Washington Medical Center

Craig Jackson, MD, MHA; Dennis Mayock, MD; Maneesh Batra, MD, MPH; and Davia Loren, MD

This clinic is held in the Maternal Infant Care Center (MICC) at UWMC where maternal‐fetal medicine specialists primarily see patients with suspected or known fetal defects for close monitoring during pregnancy, with ultrasound and non‐stress tests as needed, and genetic testing as appropriate. Neonatologists are asked to counsel patients with fetal defects about a month before the expected delivery of newborns who are at risk of needing admission to the UWMC NICU or be transported to Seattle Children’s Hospital. They also see pregnant patients with hypertension, multiple‐gestation, diabetes, and high‐risk for prematurity. Palliative care consultation from the UWMC NICU palliative care physician is available as needed. Current research projects include:

  1. Establishing growth curves for gastroschisis
  2. Prenatal bowel dilation in gastroschisis: predictors for timing of delivery and outcome
  3. cfDNA and maternal-fetal trafficking studies

 

Neuro-NICU Program

Ulrike Mietzsch, MD, - Neonatal Codirector; Nina Natarajan, MD – Pediatric Neurology Co-director

The neonatal neurocritical care program at Seattle Children’s Hospital is a specialized service to improve the care and outcome of critically ill newborns with neurological and/or neurosurgical problems diagnosed in or before the newborn period. This advanced care service provides multidisciplinary care from experts in Neonatology, Neonatal Neurology, Neurosurgery, Pediatric Neuroradiology, Pediatric Neurophysiology, Neurogenetics, Developmental Pediatrics, Occupational & Physical therapists, audiologists and speech/language pathologists.

Conditions treated:

  • Hypoxic ischemic encephalopathy (HIE)/birth asphyxia
  • Neonatal seizures
  • Brain malformations
  • Neonatal stroke
  • Metabolic encephalopathy
  • Meningitis/Encephalitis
  • Neuromuscular disorders
  • Hydrocephalus
  • Intracranial hemorrhage
  • White matter injury (PVL or diffuse)
  • ECMO monitoring
  • Myelomeningocele

Services provided:

  • 24-hour continuous video monitoring – including electrophysiologists specialized in neonatal EEG
  • Whole-body hypothermia therapy
  • Active hypothermia during neonatal critical care transports (air and ground)
  • Near-Infrared Spectroscopy Monitoring
  • Magnetic resonance imaging and spectroscopy
  • Neonatal EMG testing
  • Advanced neurogenetic diagnostics
  • Specialized small-baby care bundles
  • Comprehensive multidisciplinary High-Risk Infant Follow Up program including General Movement Assessment

Approximately 30‐40% (~180 patients) of patients admitted to the Level IV NICU at Seattle Children’s Hospital receive supplemental care through the NeuroNICU service annually. In addition, a close collaboration has been established between the NICU at UW Medical Center and the NeuroNICU at Seattle Children’s in addition to referrals and consultations from the entire State of Washington, Idaho, Montana, and Alaska, for which the NeuroNICU team is providing consultation and outreach services.

Website: https://www.seattlechildrens.org/clinics/neuro-nicu/

Infant Development Followup-up Clinic

Emily Myers, MD; Kendell German, MD; Nina Natarajan, MD

The University of Washington Center on Human Development and Disability offer the Infant Development Follow‐Up Clinic (IDFC) and the Late and Moderate Preterm Baby Clinic (LAMBs) to provide interdisciplinary neurodevelopmental assessments for infants at risk for developmental differences. Infants receive standard evaluations at 3, 9, 12, 18, and 24 months, then annually through 5 years old. Developmental Pediatrics, Neonatal Neurology, Neonatology, Advanced Practice Nursing, Psychology, Speech/Language Pathology, Audiology, Nutrition, Occupational Therapy, Physical Therapy and Social Work staff the clinic. The clinic sees approximately 2500 infants and children annually. The clinic also provides interdisciplinary training and follow‐up for patients in clinical research studies.

Infants who qualify to be seen in these clinics are those that meet any of the following criteria:

  • Infants born before 37 weeks’ gestation
  • Birthweight of <1500g
  • Infants exposed in-utero to drugs or alcohol
  • Infants with prenatal, perinatal, or neonatal brain injuries (IVH, HIE, stroke)
  • Infants with complex medical disease requiring selected surgical interventions
  • Infants who required a neonatal intensive care unit hospitalization.

Recent changes to these clinics include the introduction of the Reach Out and Read program and telehealth services which were employed during COVID restrictions. Ongoing research in the clinic includes follow‐up for the HEAL trial, the evaluation of the Reach Out and Read program in the NICU and follow‐up clinics and the creation of a patient database to facilitate quality improvement and outcomes research.

Neonatal-Perinatal Clinical Collaboratives

Vermont-Oxford Network

Michael D. Neufeld, MD, MPH; Thomas P. Strandjord, MD, Database Coordinators

The University of Washington Medical Center Neonatal Intensive Care Unit maintains a quality improvement and research NICU database that includes all infants admitted to the NICU, as well as all infants delivered at UWMC over 22 weeks' gestation. The database is maintained by Division staff and faculty. In addition, since 2000, the University of Washington NICU has participated in the Vermont‐Oxford Network (VON) database for 401‐1500‐gram infants. Data is selected for inclusion in the NICU database by consensus of the neonatology faculty and fellows. The NICU database contains a superset of the data required by the VON database and as such includes extensive admission, diagnostic, outcome and local QA/QI data. The outcome (morbidity and mortality) data are generated annually and reviewed with the faculty and fellows. In addition, ad hoc queries are performed at the request of fellows and faculty and reviewed as a group. 

Children’s Hospital Neonatal Consortium

Elizabeth Jacobson, MD, Site Physician Sponsor; Robert DiGeronimo, MD, Co-Sponsor

Seattle Children’s Hospital belongs to the Children’s Hospitals Neonatal Consortium (CHNC) of 40 children's hospital Level IV NICUs. This allows for involvement in benchmarking, quality evaluation, and improvement initiatives for the SCH NICU through the Children’s Hospitals Neonatal Database and focus groups on specific diagnoses, such as severe bronchopulmonary dysplasia, congenital diaphragmatic hernia, and hypoxic‐ischemic encephalopathy. Many of our neonatal faculty are members of one or more of the CHNC’s focus groups, including those mentioned as well as Fetal Therapy, ECMO, Necrotizing enterocolitis, Resuscitation, and Neurosurgery. In addition, Elizabeth Jacobson co‐leads the CHNC’s national Gastroschisis Focus Group. Publications from these efforts are listed in the Translational, Clinical, and Quality Improvement Research section of this Annual Report.

Extracorporeal Life Support Organization

Robert DiGeronimo, MD, Site Physician Co-Sponsor

Seattle Children’s Hospital belongs to the Extracorporeal Life Support Organization (ELSO), an international non‐profit consortium of over 350 health care institutions dedicated to the development and evaluation of novel therapies to support organ failure. Participation in ELSO affords the opportunity to participate in and query the extracorporeal membrane oxygenation database to support clinical research, quality improvement and evidence‐based guideline recommendations.

National Airway Registry for Neonates (NEAR4NEOS)

Taylor Sawyer, DO, MEd, Site Lead UWMC and SCH, Shilpi Chabra, MD, UWMC Site Co-Lead; Mihai Puia-Dumitrescu, MD, MPH, SCH Site Co-Lead  

Both the University of Washington NICU and the Seattle Children’s Hospital NICU belong to the National Airway Registry for Neonates (NEAR4NEOS), an international collaboration of 16 academic neonatal intensive care units dedicated to improving the safety of neonatal intubation. Participation in NEAR4NEOS affords the opportunity to participate in clinical research and quality improvement projects around neonatal intubation.

Regional Neonatology Outreach Program

Jose Perez, MD

The Division of Neonatology Regional Outreach program started around 1980 when the WA State Department of Health received matching federal funds for regionalization of OB and neonatal services into four centers, including the University of Washington. The UW program split into OB at UW Medical Center and neonatal at Seattle Children’s Hospital (SCH) in about 1990. After federal funding for the program ended in about 2000, SCH continued to support a neonatal educator salary until about 2010 to do needs‐assessments for referring hospitals and to teach NRP. By then, most level II and III NICUs had their own clinical nurse specialists or educators. Our neonatal outreach program initially focused on addressing the training needs of level I and II delivery hospitals, and then helped interested level II centers become level III centers. In the early 1990s, SCH began to build more durable referral relationships through LLC arrangements and neonatal/pediatric hospitalist service contracts. In the early 2000s, SCH hired a neonatologist for the level III NICU at Kadlec (until they partnered with Prov‐Sacred Heart a few years later). The neonatology outreach leader began frequent trips to sites in central WA and western MT to build personal relationships, primarily by giving didactic presentations requested by the neonatologists and reviewing the outcomes of neonatal patients they sent to SCH or UW with brief educational comments. In about 2010, our neonatology outreach program expanded to include our level III/IV NICU medical directors. We meet regularly with SCH Neonatology director Jake Hawksworth and leaders in the SCH Strategic Planning and Business Development office. In 2019, we worked with them to develop a contract to support neonatal training services in Bozeman, MT.

Research Programs
Research Programs

Research Programs

Our division faculty have research focused on neuroscience, medical education, global neonatal-perinatal health, and ethics. 

NEONATAL NEUROSCIENCE

Program Description:

Our Neonatal Neuroscience Program is focused on improving the neurodevelopmental outcomes of high‐risk infants. Components of our program include the Neonatal Neuroscience laboratory in which we carry out basic science studies to better understand mechanisms of brain injury and repair in a variety of neonatal brain injury models (rodents, ferrets and nonhuman primates), and the Brain Research Advancement in Neonatology (BRAIN) team which targets interdisciplinary clinical and translational research.

Core Programs:

  • Neonatal neuroscience laboratory (NNL)- Sandra Juul, Tommy Wood, Janessa Law, Daniel Moralejo, Kylie Corry
  • Brain Research Advancement in Neonatology (BRAIN) Team- Janessa Law, Tommy Wood, Mihai Puia-Dumitrescu, Kendell German, Krystle Perez, Ulrike Mietzsch
  • NeuroNICU- Ulrike Mietzsch, Nina Natarajan, Jason Hauptman, Sandra Juul, Francisco Perez, Dennis Shaw, Hannah Tully, Mark Wainwright, Emily Myers
  • Infant Development Follow-Up Clinic (IDFC)/Late and Moderate Preterm Babies Clinic (LAMBs)- Emily Myers, Nina Natarajan, Kendell German
  • Neuroscience Fellowship Track- Sandra Juul, Nina Natarajan, Dennis Mayock, Kendell German, Janessa Law, Mihai Puia-Dumitrescu, Ulrike Mietzsch, Megan Gray, Thomas Wood
  • PENUT and HEAL Data Coordinating Center (DCC)- Patrick Heagerty, Bryan Comstock
  • Eunice Kennedy Shriver Intellectual and Developmental Disabilities Research Center (IDDRC)- Michael Guralnick, Sandra Juul
  • Biomedical Image Computing GroupColin Studholme, Todd Richards, Manjiri Dighe

Ongoing Trials and Collaborations:

  • Preterm Epo Neuroprotection (PENUT) trial- Sandra Juul, Patrick Heagerty, Dennis Mayock, Bryan Comstock
  • High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL)- Sandra Juul, Patrick Heagerty, Dennis Mayock, Bryan Comstock
  • Washington study of Outcomes, Neural Development and Early Risk (WONDER)- Frederick Shic, Sara Webb, Dennis Mayock

Peer-reviewed publications 2020-2021:

  1. Law JB, Wood TR, Gogcu S, Comstock BA, Dighe M, Perez K, Puia‐Dumitrescu M, Shaw DW, Wright J, Widness JA, Mayock DE, Heagerty PJ, and Juul SE on behalf of the PENUT Trial consortium. Intracranial Hemorrhage and 2‐year Neurodevelopmental Outcomes in Extremely Preterm Neonates. J Pediatr. 2021 Jul 1:S0022‐3476(21)00653‐3. doi: 10.1016/j.jpeds.2021.06.071. Epub ahead of print. PMID: 34217769.
  2. Berube MW Berube, Puia‐Dumitrescu M, McAdams RM. Does mild hypoxic ischemic encephalopathy adversely affect neurodevelopmental outcome? J Perinatol. 2021 Apr;41(4):901‐904. doi: 10.1038/s41372‐021‐01026‐5. Epub 2021 Mar 13. PMID: 33714978.
  3. Scholl J, Mailing L, Wood TR. Reframing nutritional microbiota studies to reflect an inherent metabolic flexibility of the human gut. mBIO 2021, 12:2.
  4. Askenazi D; Heagerty PJ; Schmicker RH; Griffin R; Brophy P; Juul SE; Mayock DE; Goldstein SL; Hingorani. S Prevalence of Acute Kidney Injury (AKI) in Extremely low Gestational Age Neonates (ELGANs): Results from the Recombinant Erythropoietin for Protection of Infant Kidney Disease (REPaIReD) Study. Pediatric Nephrology, 2020 Jun 2. doi: 10.1007/s00467‐020‐04563‐x. PMID: 32488672
  5. Juul SE, Comstock BA, Wadhawan R, Mayock DE, Courtney SE, Robinson T, Ahmad KA, Bendel‐ Stenzel E, Baserga M, LaGamma EF, Downey LC, Rao R, Fahim N, Lampland A, Frantz, ID, Khan JY, Weiss M, Gilmore MM, Ohls RK, Srinivasan N, Perez JE, McKay V, Vu PT, Lowe J, Kuban K, O’Shea M, Hartman AL, Heagerty PJ, on behalf of the PENUT Trial Consortium. A Randomized trial of Erythropoietin for Neuroprotection in Preterm Infants. N Engl J Med 2020;382:233‐43. DOI: 10.1056/NEJMoa1907423 PMID: 31940698, PMCID: , PMCID: PMC7060076 (available on 2020‐ 07‐16)
  6. Juul SE; Vu PT; Comstock BA; Wadhawan R; Mayock DE; Courtney SE; Robinson T; Ahmad KA; Bendel‐Stenzel E; Baserga M; LaGamma EF; Downey LC; O’Shea M; Rao R; Fahim N; Lampland A; Frantz, III ID; Khan J; Weiss M; Gilmore MM; Ohls RK; Srinivasan N; Perez JE; McKay V; Heagerty PJ; for the PENUT Trial Consortium. The Effect of High Dose Erythropoietin on Blood Transfusions in Extremely Low Gestational Age Neonates: A Randomized Clinical Trial. JAMA Peds In Press Aug 17, 2020
  7. Juul SE, Comstock BA, Heagerty PJ. Erythropoietin in Preterm Infants. Reply. N Engl J Med. 2020 May 7;382(19):1862‐1863. doi: 10.1056/NEJMc2002493. PMID: 32374969
  8. Liao R, Wood TR, Nance EA. Nanotherapeutic modulation of excitotoxicity and oxidative stress in acute brain injury. Nanobiomedicine. January 2021.
  9. Liao R, Wood TR, Nance E. Superoxide dismutase reduces monosodium glutamate‐induced injury in an organotypic whole hemisphere brain slice model of excitotoxicity. J Biol Eng 14, 3 (2020).doi: 10.1186/s13036‐020‐0226‐8
  10. Chalak L, Redline RW, Goodman AM, Juul SE, Chang T, Yanowitz TD, Maitre N, Mayock DE, Lampland AL, Bendel‐Stenzel E, Riley D, Mathur AM, Rao R, Van Meurs KP, Wu TW, Gonzalez FF, Flibotte J, Mietzsch U, Sokol GM, Ahmad KA, Baserga M, Weitkamp JH, Poindexter BB, Comstock BA, Wu YW. Acute and Chronic Placental Abnormalities in a Multicenter Cohort of Newborn Infants With Hypoxic‐Ischemic Encephalopathy. J Pediatr. 2021 Jun 15:S0022‐3476(21)00553‐9. doi: 10.1016/j.jpeds.2021.06.023. Online ahead of print.
  11. Potter GDM, Wood TR. The Future of Shift Work: Circadian Biology Meets Personalised Medicine and Behavioural Science. Front. Nutr. 7:116. Doi: 10.3389/fnut.2020.00116
  12. Puia‐Dumitrescu M, Comstock BA, Li S, Heagerty PJ, Perez KM, Law JB, Wood TR, Gogcu S, Mayock SE, Juul SE. Assessment of 2‐year neurodevelopmental outcomes in extremely preterm infants managed with opioids and benzodiazepines. JAMA Netw Open. 2021 Jul 1;4(7):e2115998. doi: 10.1001/jamanetworkopen.2021.15998. PMID: 34232302; PMCID: PMC8264640. Puia‐Dumitrescu M, Sullivan LN, Tanaka D, Fisher K, Pittman R, Kumar KR, Malcolm WF, Gustafson KE, Lodge AJ, Goldberg RN, Hornik CP. Survival, Morbidities, and Developmental Outcomes among Low Birth Weight Infants with Congenital Heart Defects. Am J Perinatol. 2020 Jun 2. PMID: 32485756.
  13. Rico Mora DA, Perez KM, Parikh JM, Chatterjee D, George P, O'Reilly‐Shah V, Rollins M, Sinskey JL, Patak L. Improvement in perioperative anesthesia documentation for fetal interventions. Paediatr Anaesth. 2020 Jun 27. doi: 10.1111/pan.13955. Epub ahead of print. PMID: 32594611.
  14. Wood T, Moralejo D, Corry K, Fisher C, Snyder JM, Acuna V, Holden‐Hunt A, Virk S, White O, Law J, Parikh P, Juul SE. A Ferret Model of Inflammation‐sensitized Late Preterm Hypoxic‐ischemic Brain Injury. J Vis Exp. 2019 Nov 19;(153). doi: 10.3791/60131. PMID: 31814608
  15. Wood TR, Vu PT, Comstock BA, Law JB, Mayock DE, Heagerty PJ, Burbacher T, Bammler TK, Juul SE. Cytokine and chemokine responses to injury and treatment in a nonhuman primate model of hypoxic‐ischemic encephalopathy treated with hypothermia and erythropoietin. J Cereb Blood Flow Metab. 2021 Feb 7:271678X21991439. doi: 10.1177/0271678X21991439. Epub ahead of print. PMID: 33554708.
  16. Wood TR, Gundersen JK, Falck M, Maes E, Osredkar D, Løberg EM, Sabir H, Walløe L, Thoresen
  17. M. Variability and sex‐dependence of hypothermic neuroprotection in a rat model of neonatal hypoxic–ischaemic brain injury: a single laboratory meta‐analysis. Sci Rep 10, 10833 (2020). doi: 10.1038/s41598‐020‐67532‐2

  18. Goldin AB, Raval MV, Thurm CW, Hall M, Billimoria Z, Juul SE, Berman L. The Resource Utilization Inflection Point for Safe NICU Discharge. Pediatrics 2020;146.
  19. Kristi Watterberg for the COMMITTEE ON FETUS AND NEWBORN: James J Cummings, Ira S Adams‐Chapman, Susan Wright Aucott, Jay P Goldsmith, Ivan L Hand, Sandra E Juul, Brenda Bradley Poindexter, Karen Marie Puopolo, Dan L Stewart, Wanda D Barfield. Providing Care for Infants Born at Home. Pediatrics 2020 May;145(5):e20200626. doi: 10.1542/peds.2020‐0626. Epub 2020 Apr.
  20. Mayock DE, Xie Z, Comstock BA, Heagerty PJ, Juul SE, on behalf of the Preterm Epo Neuroprotection (PENUT) Trial Consortium.* High Dose Erythropoietin in ELGANs does not Alter Risk of Retinopathy of Prematurity. Neonatology 2020:1‐8
  21. Vu TV, Ohls RK, Mayock DE, German KR, Comstock, BA Heagerty PJ, Juul SE. Transfusions and Neurodevelopmental Outcomes in Extremely Low Gestation Neonates Enrolled in the Preterm Erythropoietin Neuroprotection (PENUT) Trial. Peds Res 2021. doi: 10.1038/s41390‐020‐01273‐ w
  22. Pang R, Avdic‐Belltheus A, Meehan C, Martinello K, Mutshiya T, Yang Q, Sokolska M, Torrealdea F, Hristova M, Bainbridge A, Golay X, Juul SE and Robertson NJ. Melatonin and/or erythropoietin combined with hypothermia in a piglet model of perinatal asphyxia. Brain Communications 2020. doi:10.1093/braincomms/fcaa211
  23. Massaro AN, Bammler TK, Macdonald JW, Perez KM, Comstock B, Juul SE. Whole genome methylation and transcriptome analyses to identify risk for cerebral palsy (CP) in extremely low gestational age neonates (ELGAN). Scientific reports. 2021;11(1).
  24. Askenazi D, Heagerty PJ, Schmicker RH, Brophy P, Juul SE, Goldstein SL, Sangeerta Hingorani S. The Impact of Erythropoietin on Short and Long‐term Kidney‐Related Outcomes in Extremely Low Gestational Age Neonates: Results of a Multi‐Center Double‐Blind Placebo‐Controlled Randomized Clinical Trial. J Pediatr. 2021 Jan 20. pii: S0022‐3476(21)00065‐2. doi: 10.1016/j.jpeds.2021.01.031.
  25. Wisnowski JL, Bluml S, Panigrahy A, Mathur AM, Berman J, Chen PK, Dix J, Flynn T, Fricke S, Friedman SD, Head HW, Ho CY, Kline‐Fath B, Oveson M, Patterson R, Pruthi S, Rollins N, Ramos YM, Rampton J, Rusin J, Shaw DW, Smith M, Tkach J, Vasanawala S, Vossough A, Whitehead MT, Xu D, Yeom K, Comstock B, Heagerty PJ, Juul SE, Wu YW, McKinstry RC; HEAL Study Group: Ahmed K, Beserga M, Bendel‐Stenzel E, Chalak L, Chang T, Flibotte J, Gonzalez F, Lampland A, Maitre N, Mayock DM, Mietzsch U, Poindexter B, Rao R, Riley R, Sokol GM, Van Meurs K, Weitkamp H, Wu TW, Yanowitz T                                                  Integrating neuroimaging biomarkers into the multicentre, high‐dose erythropoietin for asphyxia and encephalopathy (HEAL) trial: rationale, protocol and harmonisation. BMJ Open. 2021 Apr 22;11(4):e043852. doi: 10.1136/bmjopen‐ 2020‐043852.PMID: 33888528
  26. German, KR, Vu PT, Neches S; Juul SE. Comparison of markers of iron sufficiency status and neurodevelopmental outcomes. Early Hum Dev. 2021 May 19;158:105395. doi: 10.1016/j.earlhumdev.2021.105395. Online ahead of print. PMID: 34082259
  27. Mayock DE, Gogcu S, Puia‐Dumitrescu M, Shaw DWW, Wright JN, Comstock BA, Heagerty PJ, Juul SE, for the PENUT Trial Consortium. Association between Term Equivalent Brain MRI and 2 Year Outcomes in Extremely Preterm Infants: A Report from the PENUT Trial Cohort. J Peds In press
  28. Corry KA, White OR, Shearlock AE, Moralejo DH, Law JB, Snyder JM, Juul SE, Wood TR. Evaluating Neuroprotective Effects of Uridine, Erythropoietin, and Therapeutic Hypothermia in a Ferret Model of Neonatal Encephalopathy. International Journal of Molecular Sciences. In press
  29. Wood TR, Parikh P, Comstock BA, Law JB, Bammler TK, Mayock DE, Heagerty PJ, and Juul SE for the PENUT Trial consortium. Early Biomarkers of Hypoxia and Inflammation and Two‐Year Neurodevelopmental Outcomes in the Preterm Erythropoietin Neuroprotection (PENUT) Trial. EBioMedicine In press
  30. Hingorani S, Schmicker RH, Brophy PD, Heagerty PJ, Juul SE, Goldstein SL, Askenazi D. for the PENUT investigators. Severe Acute Kidney Injury (AKI) and Mortality in Extremely Low Gestational Age Neonates (ELGANs). Clinical Journal of the American Society of Nephrology (CJASN) Clin J Am Soc Nephrol. 2021 Jun;16(6):862‐869. doi: 10.2215/CJN.18841220. Epub 2021 Jun 11. PMID: 34117080
  31. Law JB, Wood TR, Gogcu S, Comstock BA, Dighe M, Perez K, Puia‐Dumitrescu M, Mayock DE, Heagerty PJ, Juul SE. Intracranial Hemorrhage and 2‐year Neurodevelopmental Outcomes in Extremely Preterm Neonates. J Pediatrics, In press
  32. German KR; Vu PT; Comstock BA; Ohls RK; Heagerty PJ; Mayock DE; Georgieff M; Juul SE; for the PENUT Consortium. Enteral Iron Supplementation in Extremely Preterm Infants and its Positive Correlation with Neurodevelopment; Post Hoc Analysis of the PENUT Randomized Controlled Trial. J Pediatr In Press
  33. Elliott Mark Weiss, Katherine F Guttmann, Aleksandra E Olszewski, Brooke E Magnus, Sijia Li, Scott YH Kim, Anita R Shah, Sandra E Juul, Yvonne W Wu, Kaashif A Ahmad, Ellen Bendel‐Stenzel, Natalia A Isaza, Andrea L Lampland, Amit M Mathur, Rakesh Rao, David Riley, David G Russell, Zeynep N I Salih, Carrie B Torr, Joern‐Hendrik Weitkamp, Uchenna E Anani, Taeun Chang, Juanita Dudley, John Flibotte, Erin M Havrilla, Alexandra C O’Kane, Krystle Perez, Brenda J Stanley, Seema K Shah, Benjamin S Wilfond. The Parental Experience of Recruitment for a Neonatal Clinical Trial. J Pediatr In Press


Chapters 2020-2021:

  1. Kolnik S, German K, Juul SE. Hematologic agents. Ch 58. Yaffe and Aranda's Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice
  2. Long C, Campbell, DE. Discharge Planning for the High-Risk Newborn Requiring Intensive Care. American Academy of Pediatrics Neonatology for Primary Care, 2nd edition, Campbell DE, (ed), Elk Grove, IL: 2020.
  3. Nafday S, Long C. Respiratory Distress and Breathing Disorders in the Newborn. American Academy of Pediatrics Neonatology for Primary Care, 2nd edition, Campbell DE (ed), Elk Grove Village, IL: 2020.
  4. Natarajan N, Mietzsch U, Juul SE. Encephalopathy of Prematurity IN: Evidence Based Neonatology. In Press
  5. Rios A, Shur N. Chapter 31. Specific Congenital Metabolic Diseases. Neonatology for Primary Care 2ND Edition AAP, Editor: Deborah E. Campbell MD

 

Invited presentations 2020-2021:

 

    1. Juul, SE. Grand Rounds, Royal Womens Hospital, Melbourne Australia. April 2020. Update on Clinical Trials for Neonatal Neuroprotection.
    2. Law, JB. University of Washington Department of Pediatrics‐Quarterly Research Meeting, Seattle, Washington. Nov 2020. Topic: BRAIN (Brain Research Advancement in Neonatology) Team
    3. Wood, TR. University of Washington Department of Pediatrics‐Quarterly Research Meeting, Seattle, Washington. Nov 2020. Topic: Neonatal Neuroscience Lab (NNL) Overview
    4. Wood, TR. Institute for Human and Machine Cognition evening seminar series. Feb 2020. Topic: Brain Health Across the Lifespan.
    5. Wood, TR. Pediatric Academic Societies Graduate Program in Neonatal Neurology. May 2021. Topic: Designing a Research Question in Basic Science.
    6. Juul, SE. Pediatric Academic Societies Graduate Program in Neonatal Neurology. May 2021. Topic: Designing a Research Question in Translational Science.
    7. Juul, SE: RMIT, Melbourne Australia, May 2020. PENUT Results
    8. Juul, SE. JENS conference keynote speaker, July 2020. Update on PENUT Results.
    9. Juul, SE. Grand rounds, University of Utah, Oct 29, 2020. What the PENUT Trial taught me.
    10. Juul, SE. Neonatal Brain Club, Cleveland Clinic, Nov 2020. Learnings from the Preterm Epo Neuroprotection Trial.
    11. Juul, SE. WSPR keynote speaker, Jan 2021. Neonatal Anemia and Iron Management in the Newborn.
    12. Juul, SE. PAS 2021: Hormonal Therapy for Neonatal Brain Injury: Epo Neuroprotection.
    13. Juul, SE. PAS 2021: A Tribute to Maria Delivoria‐Papadopoulos. From Bench to Bedside, My Personal Research Journey.
    14. Juul, SE. PAS 2021: Designing a Research Question: Translational Research
    15. Juul, SE. PAS 2021: Outcomes of HIE

NEONATAL EDUCATION AND SIMULATION-BASED TRAINING (NEST) PROGRAM

Investigators: Rachel Umoren, MBBCh, MS, Program Director, Director for Immersive Learning and Telesimulation; Taylor Sawyer, DO, MBA, MEd, Director of Outreach Education; Thomas Strandjord, MD, Director of Clinical Integration; Megan M. Gray, MD, Director of Research; Zeenia Billimoria, MD, Director of ECMO and Transport Simulation; Sarah Handley, MD, Associate Director of Outreach Education; Chris Cooper, ARNP, NNP, DNP, MBA, Associate Director of Clinical Integration; Krista Birne MD, Associate Director of Telesimulation; Maneesh Batra, MD, MPH, Elena Bosque PhD, ARNP, NNP‐BC. Sara Berkelhamer, MD.

Program Description:

In 2014, the Division of Neonatology joined an elite group of neonatal divisions who own and operate a dedicated neonatal simulation program. The Neonatal Education and Simulation‐ based Training (NEST) Program sets the UW and Seattle Children’s Division of Neonatology apart and highlights the Division’s dedication to simulation‐based education. The mission of the NEST Program is to improve neonatal outcomes through advanced technology‐enhanced  training  and  simulation  research. The program’s vision is to provide global leadership in neonatal education, simulation‐based training and scholarship. Current projects include: ‘boot camps’ for residents and fellows, neonatal resuscitation training, neonatal procedural skills training, development of a computer‐based perinatal counseling simulator, and virtual reality neonatal disaster training. The NEST program works to improve the care of neonates in the Seattle region by conducting educational outreach with pediatric providers and neonatal transport teams.

Peer-reviewed publications 2020-2021:

NEST resident or fellow

  1. French H, Arias‐Shah AM, Gisondo C, Gray MM. The Flipped Classroom in Graduate Medical Education. NeoReviews. 2020 March; 21 (3): e150‐156. PMID: 32123119
  2. Gray MM, Dadiz R, Izatt S, Gillam‐Krakauer M, Carbajal M, Bonachea E, Falck A, Johnston L, Karpen H, Vasquez M, Chess P, French H. Value, Strengths, and Challenges of e‐Learning Modules Paired with the Flipped Classroom for Graduate Medical Education: A Survey from the National Neonatology Curriculum. American Journal of Perinatology. Epub ahead of print 2020 April. PMID: 32276279
  3. Gray MM, Erika E, Ehret D, Brei B, Greenberg L, Umoren R, Ringer S, Horbar J. Opportunities for Resuscitation of Very and Extremely Low Birth Weight Infants During Fellowship. Pediatrics. Jun 2020, e20193641; 2019‐3641.
  4. Gray MM, Thomas AA, Burns B, Jones N, Umoren R. Evacuation of Vulnerable and Critical Patients (EVAC): Multimodal simulation for nurse‐led patient evacuation. Simulation in Healthcare. 2020 May 4. Epub ahead of print. PMID: 32371747.
  5. Hippe DS, Umoren RA, McGee A, Bucher SL, Bresnahan BW. A targeted systematic review of cost analyses for implementation of simulation‐based education in healthcare. SAGE Open Medicine. 2020 Mar;8:2050312120913451.
  6. Keilman AE, Umoren R, Lo M, Roberts J, Yoshida H, Hartford E, Patrao F, Burns B, Fenstermacher S, Masse E, Reid J. Virtual protective equipment: Paediatric resuscitation in the COVID‐19 era. BMJ Simulation and Technology Enhanced Learning. 2020 May 17:bmjstel‐2020.
  7. Kemper KJ, Schwartz A, Wilson PM, Mahan JD, Schubert CJ, Staples BB, McClafferty H, Serwint JR, Batra M on behalf of the Pediatric Resident Burnout‐Resilience Study Consortium. “Burnout in Pediatric Residents: Three Years of National Survey Data.” Pediatrics. 2020 Jan;145(1). PMID: 31843859
  8. Kukora S, Batell B, Umoren R, Gray MM, Ravi N, Thompson C, Zikmund‐Fisher B. Hilariously Bad News: Medical Improv as a Novel Approach to Teach Communication Skills for Bad News Disclosure. Academic Pediatrics. 2020 May 7; S1876‐2859. PMID: 32389759.
  9. Morris A, Bosque E. Do we nurture our young? Qualitative conceptual analysis of worst and best mentorship experiences among neonatal advanced practice providers. Adv Neonatal Care. 2020; In press.
  10. Shieh C, Khan I, Umoren R. Engagement design in studies on pregnancy and infant health using social media: Systematic Review. Preventive Medicine Reports. 2020 May 8:101113.
  11. Thomas A, Gray MM, Burns B, Umoren R. EVAC: Evacuation of Vulnerable and Critical Pediatric Patients for Nurses. Cureus. 2020 May; 12(5): e8302. PMID: 32601574.
  12. Umoren R, Ezeaka VC, Fajolu IB, Ezenwa BN, Akintan P, Chukwu E, Spiekerman C. Perspectives on simulation‐based training from paediatric healthcare providers in Nigeria: a national survey. BMJ open. 2020 Feb 1;10(2).
  13. Sawyer T, Billimoria Z, Handley S, Smith K, Yalon L, Brogan TV, DiGeronimo R. Therapeutic plasma exchange for neonatal septic shock: A retrospective cohort study. Am J Perinatol. 2020 Jul;37(9):962‐969. PMID: 31176309.
  14. Foglia E, Jensen E, Wyckoff M, Sawyer T, Topjian A, Ratcliffe S. Survival after delivery room cardiopulmonary resuscitation: A national registry study. Resuscitation. 2020 Jul;152:177‐183. PMID: 31982507.
  15. Sawyer T. Educational strategies to improve outcomes from neonatal resuscitation. NeoReviews. 2020 July. 21(7):e431‐e441. PMID: 32611561.
  16. Robinson K, Tang H, Metzenberg E, Peterson J, Umoren R, Sawyer T. Socially distanced Neonatal Resuscitation Program (NRP): A technical report on how to teach NRP courses during the COVID‐ 19 pandemic. Cureus. 2020 Oct; 12(10): e10959. PMID: 33209520.
  17. Sawyer T, Stavroudis TA, Ades A, Dadiz R, Dammann CEL, Halamek LP, Moussa A, Soghier L, Gupta A, Aliaga S, Umoren R, French H. Simulation in neonatal‐perinatal medicine fellowship programs. Am J Perinatol. 2020 Oct;37(12):1258‐1263. PMID: 31307105.
  18. Yeung J, Djarv T, Hsieh MJ, Sawyer T, Lockey A, Finn J, Greif R. Spaced learning versus massed learning in resuscitation: A systematic review. Resuscitation. 2020 Nov;156:61‐71. PMID: 32926969.
  19. Sawyer T. Simulation training in extracorporeal cardiopulmonary resuscitation (ECPR). Acad Pediatr. 2020 Nov 13;S1876‐2859(20)30578‐7. PMID: 33189906.
  20. Sawyer T. Neonatal resuscitation: airway, breathing, and then chest compressions. Resuscitation. 2020 Nov 9;S0300‐9572(20)30549‐9. PMID: 33181228.
  21. Ali N, Lam T, Gray M, Clausen D, Riley M, Grover T, Sawyer T. Cardiopulmonary resuscitation in quaternary neonatal intensive care units: A multicenter study. Resuscitation. 2020 Dec 23;S0300‐ 9572(20)30607‐9. PMID: 33359416.
  22. Umoren R, Sawyer T, Ades A, DeMeo SD, Foglia E, Glass K, Gray M, Barry J, Johnston L, Jung P, Kim J, Krick J, Moussa A, Mulvey C, Nadkarni V, Napolitano N, Quek BH, Singh N, Zenge J, Shults J, Nishisaki A. Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS. Am J Perinatol. 2020 Dec;37(14):1417‐1424. PMID: 31365934.
  23. Brei B, Neches S, Gray M, Handley S, Castera M, Hedstrom A, d’Cruz R, Kolnik S, Strandjord T, Mietzsch U, Cooper C, Moore M, Billimoria Z, Sawyer T, Umoren R. Telehealth Training during the COVID‐19 Pandemic: A Feasibility Study of Large Group Multiplatform Telesimulation Training. Telemed J E Health. 2020 Dec 30. Doi: 10.1089/tmj.2020.0357. PMID: 33395364
  24. Bucher SL, Cardellichio P, Muinga N, Patterson JK, Thukral A, Deorari AK, Data S, Umoren R, Purkayastha S. Digital Health Innovations, Tools, and Resources to Support Helping Babies Survive Programs. Pediatrics. 2020 Oct;146(Suppl 2):S165‐S182. doi: 10.1542/peds.2020‐ 016915I. PMID: 33004639.
  25. Burns R, Gray M, Peralta D, Scheets A, Umoren R. TeamSTEPPS online simulation: expanding access to teamwork training for medical students. BMJ Simulation and Technology Enhanced Learning. 2021 Jan 6:bmjstel‐2020.
  26. Staples BB, Burke AE, Batra M, Kemper KJ, Schwartz A, Wilson PM, Schubert CJ, Mahan JD, Serwint JR, Pediatric Resident Burnout‐Resilience Study Consortium. Burnout and Association With Resident Performance as Assessed by Pediatric Milestones: An Exploratory Study. Academic pediatrics. 2021 Mar 1;21(2):358‐65.
  27. Webber S, Schwartz A, Kemper KJ, Batra M, Mahan JD, Babal JC, Sklansky DJ, Pediatric Resident Burnout‐Resilience Study Consortium. Faculty and Peer Support During Pediatric Residency: Association With Performance Outcomes, Race, and Gender. Academic Pediatrics. 2021 Mar 1;21(2):366‐74.
  28. Umoren R, Kim S, Gray MM, Best JA, Robins L. Interprofessional model on speaking up behaviour in healthcare professionals: a qualitative study. BMJ Leader. 2021 Apr 26:leader‐2020.
  29. Kim AJ, Umoren R, Gray MM. Teaching Antenatal Counseling Skills via Video Conference. Cureus. 2021 Aug 9;13(8).
  30. Du N, Forson‐Dare Z, Sawyer T, Bruno C, Asnes A, Shabanova V, Ades A, French H, Johnston L Procedural competency for pediatric residents in the contemporary training environment: an unachievable?' MedEdPublish. 2021 Jan;10(1):28. https://doi.org/10.15694/mep.2021.000028.1
  31. Brei B, Gray M, Umoren R, Handley S, DiGeronimo R, Smith K, Sawyer T, Billimoria Z. Interprofessional ECMO telerounding: A novel approach to neonatal ECMO clinical participation and education. J Perinatol. 2021 Apr;41(4):824‐829. PMID: 32963301.
  32. Gray M, Rumpel J, Krick J, Sawyer T, Glass K, DeMeo S, Barry J, Ades A, Napolitanon N, Johnston L, Moussa A, Jung P, Quek B, Mehrem AA, Zenge J, Shults J, Nadkarni V, Kim J, Singh N, Tisnic A, Foglia E, Nishisaki N. Associations of stylet use during neonatal intubation with intubation success, adverse events, and severe desaturation: A report from NEAR4NEOS. Neonatology. 2021 May 4;1‐ 9. PMID: 33946064
  33. Johnston L, Sawyer T, Ades A, Moussa A, Zenge JP, Jung P, DeMeo S, Glass KM, Singh N, Howlett A, Shults J, Barry J, Brei B, Foglia E, Nishisaki A. Impact of physician training level on neonatal tracheal intubation success rates and adverse events in neonatal intensive care units: A report from NEAR4NEOS. Neonatology. 2021 Jun 10;1‐9. PMID: 34111869
  34. Evans P, Shults J, Weinberg D, Napolitano N, Ades A, Glass C, Brei B, Krick J, Sawyer T, Moussa A, Verreault A, Hollenberg J, Rumpel J, Mehrem A, Howlett A, McKanna J, Johnston L, Levit O, Nishisaki A, Foglia E. Establishing intubation competency during neonatal fellowship training. Pediatrics. 2021. Jun; e2020036145; PMID: 34172556.
  35. Brei B, Sawyer T, Umoren R, Gray M, Krick J, Foglia E, Ades A, Glass K, Kim J, Singh N, Jung P, Johnston L, Moussa A, Napolitano N, Barry J, Zenge J, Quek BH, DeMeo S, Shults J, Nadkarni V, Nishisaki A. Associations between family presence and neonatal intubation outcomes: A report
  36. from the National Emergency Airway Registry for Neonates (NEAR4NEOS). Arch Dis Child Fetal Neonatal Ed. 2021 Jul;106(4):392‐397. PMID: 33478956.

  37. Litke‐Wager C, Delaney H, Mu T, Sawyer T. Impact of task‐oriented role assignment on neonatal resuscitation performance: A simulation‐based randomized controlled trial. Am J Perinatol. 2021 Jul;38(9):914‐921. PMID: 31899928
  38. Sawyer T, Gray M, Chabra S, Johnston LC, Carbajal MM, Gillam‐Krakauer M, Brady JM, French H. Milestone level changes from residency to fellowship: A multi‐center cohort study. J Grad Med Educ. 2021 Jun;13(3):377‐384. PMID: 34178263.
  39. Staples B, Burke A, Batra M, Kemper K, Schwartz A, Wilson P, Schubert C, Mahan J, Serwint J, on behalf of the Pediatric Resident Burnout‐Resilience Study Consortium. “Burnout affects resident competency as assessed by pediatric milestones.” Academic Pediatrics. 2021 Mar;21(2):358‐ 365. PMID:32795689.
  40. Umoren RA, Bucher S, Hippe D, Ezenwa B, Fajolu I, Okwako F, Feltner J, Nafula M, Mmboga A, Olawuyi O, Adeboboye C, Asangansi I, Paton C, Purkayastha S, Ezeaka C, Esamai F. eHBB: A randomized controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource scarce settings. Accepted for publication in BMJ Open.
  41. Webber S, Schwartz A, Kemper K, Batra M, Mahan J, Babal J, Sklansky D, on behalf of the Pediatric Resident Burnout‐Resilience Study Consortium. “Faculty and Peer Support during Pediatric Residency: Association with Performance Outcomes, Race and Gender.” Academic Pediatrics. 2021 Mar;21(2):366‐374. PMID:32798725.
  42. Berkelhamer S, McMillan D, Amick E, Singhal N, Bose C. Beyond Newborn Resuscitation: Essential Care for Every Baby and Small Babies, Pediatrics, Oct 2020.
  43. Berkelhamer S, Alden E. Helping Babies Breathe: From Implementation to Impact, Pediatrics, Sept 2020.
  44. Amsalu R, Schulte‐Hillen C, Garcia D, Lafferty N, Morris C, Gee S, Akseer N, Scudder E, Sami S, Barasa S, Had H, Maalim M, Moluh S, Berkelhamer S. Lessons Learned from Helping Babies Survive in Humanitarian Settings, Pediatrics, Oct 2020.
  45. Berkelhamer SK, Ehret DE. Striving for an Equal Chance of Survival, Pediatrics, Oct 2020.

Chapters 2020-2021:

  1. Umoren R, Rybas N. Who Am I as a Healthcare Provider?: Identity and Transformative Learning in Virtual Environments. In Virtual and Mobile Healthcare: Breakthroughs in Research and Practice 2020 (pp. 1028‐1043). IGI Global.
  2. Umoren RA, Thomas P. Immersive Learning: Virtual and Augmented Reality. AAP Neonatal Simulation Guidebook. American Academy of Pediatrics. Forthcoming in 2020.
  3. Sawyer T, Ali N. Resuscitation of the Newborn. In: Gomella T, ed. Neonatology: Management, Procedures, on‐Call Problems, Diseases, and Drugs. 8th Ed. Stamford, Conn: Appleton & Lange; 2020: 19‐30.
  4. Sawyer T, Gray M. Debriefing ECMO simulation: Special Considerations. In Johnston L and Su L, eds. Comprehensive Healthcare Simulation: ECMO Simulation: A Theoretical and Practical Guide. New York, NY. Springer Publishing; 2021: 131‐139.
  5. Sawyer T, Gray M, Umoren R. Umbilical line placement. In: Soghier L, Robin B, eds. Neonatal Simulation Guidebook. Chicago, IL: American Academy of Pediatrics; 2021: 75‐84.
  6. Sawyer T, Gray M, Umoren R. Manikins and Task Trainers. In: Soghier L, Robin B, eds. Neonatal Simulation Guidebook. Chicago, IL: American Academy of Pediatrics; 2021: 45‐58.
  7. Sawyer T. Resuscitation Outside the Delivery Room. In Weiner G, Zaichkin J, eds. The Textbook of Neonatal Resuscitation. Elk Grove, IL. American Academy of Pediatrics; 2021: 289‐306.

Other publications and training materials 2020-2021:

  1. Wood, J. (January 18, 2020). Neo baby review: Neonatal nurse practitioner board exam review. Primedia eLaunch LLC
  2. Wood, J. (January 18, 2020). Neo baby review: Low Risk Neonatal Certification Review for RNC. Primedia eLaunch LLC

Invited presentations 2020-2021:

  1. Batra M. “Medical Education: Burnout/Resilience/Wellness.” Platform Presentation Session Moderator, Pediatric Academic Societies Annual Meeting, Philadelphia, PA, May 2‐5, 2020. [Meeting cancelled due to COVID‐19 concerns].
  2. Batra M. “Developing a Culture of Well‐Being Across Generations in Pediatrics: Priorities for Institutions and Practitioners.” State of the Art Plenary Chair, Pediatric Academic Societies Annual Meeting, Philadelphia, PA, May 2‐5, 2020. [Meeting cancelled due to COVID‐19 concerns].
  3. Batra M. “Setting the Stage: Well‐Being Across Generations.” State of the Art Plenary Speaker, Pediatric Academic Societies Annual Meeting, Philadelphia, PA, May 2‐5, 2020. [Meeting cancelled due to COVID‐19 concerns].
  4. Batra M. “What’s New in Pediatric Resident Well‐being” APA Well‐being and Vitality SIG Plenary Speaker, Philadelphia, PA, May 2‐5, 2020. [Meeting cancelled due to COVID‐19 concerns].
  5. Batra M. “Burnout, Resilience and Well‐being.” Cincinnati Children’s Hospital GME Fellows’ Rounds. December 17, 2020.
  6. Umoren R. Virtual Simulation for Communication of Patient Safety Issues. Simulation‐based Medical Education Special Interest Group. 2019 Pediatric Academic Societies Meeting. Philadelphia PA. May 4, 2020. [Meeting cancelled due to COVID‐19 concerns].
  7. Sawyer T. “Perfecting Your Performance Skills Station: Applying Motor Learning Theory to your NRP Course” American Academy of Pediatric Neonatal Resuscitation Program Live Webinar. June, 2020
  8. Berkelhamer S. “Helping Babies Survive: Lessons Learned” Building Newborn Care in Humanitarian Settings, Stavanger, Norway. Jan, 2020.
  9. Umoren RA, Sawyer T. “UW team’s experience: Teamwork & Principles of Psychological Safety” in Teamwork: Psychological Safety. Vermont Oxford Network NICQ/iNICQ Webinar. Online. February 24, 2021.
  10. Umoren RA. “Serious Gaming, Augmented Reality and Virtual Simulations”. Harvard Macy Transforming Your Teaching for the Virtual Environment. April 13, 2021.
  11. Umoren RA. “Digital Presence and Digital Scholarship”. Academic Pediatric Association Educational Scholarship Program. Pediatric Academic Societies Virtual Meeting. April 30, 2021.

TRANSLATIONAL, CLINICAL, AND QUALITY IMPROVEMENT RESEARCH

Investigators: Zeenia Billimoria, MD; Shilpi Chabra, MD; Robert DiGeronimo, MD; Kendell German, MD; MD; Elizabeth Jacobson, MD; Sandra Juul, MD, PhD; Dennis Mayock, MD; Ulrike Mietzsch, MD; Mihai Puia‐Dumitrescu, MD, MPH; Taylor Sawyer, DO, MEd; Thomas Strandjord, MD; Rachel Umoren, MD, MS; Elliott Weiss, MD, MSME; Steve Welty, MD

Program Description:

The Outcomes Research Collaborative is dedicated to improving the health and healthcare received by neonates in our units locally, regionally and nationally. Our diverse group performs innovative research in the fields of neonatal epidemiology and pharmacoepidemiology, health services research studying the impact of variation in clinical practice and outcomes, resource utilization and disparities in perinatal and neonatal healthcare. We develop and perform research projects and studies through our active affiliations with the Children’s Hospitals Neonatal Consortium (CHNC) and the Vermont Oxford Network (VON). We participate and lead pharmaceutical trials for new drugs and devices. We utilize large regional and national datasets to study short‐ and long‐term outcomes on neonates.

Our division has established a local Quality Improvement Microsystem at Children’s and a larger Regional Quality Improvement Program that oversees collaborative QI work done across all our NICUs in the region.

As practicing physicians, we always prioritize the patient. Our group conducts innovative research to deliver on our mission to share knowledge that improves the outstanding evidence‐based care of patients in our units and outside, and to educate the next generation of clinicians and researchers. This is possible through high quality translational, clinical and QI research. One of the goals of our group is to improve neonatal and pediatric therapeutics by establishing proper guidelines, dosing, safety, and efficacy of drugs and devices used in infants and children through research in pharmacotherapy, trials, and pharmacoepidemiology. We develop and perform research projects and studies through our active affiliations with the Children’s Hospitals Neonatal Consortium and the Vermont Oxford Network. We participate and lead pharmaceutical trials for new drugs and devices. We also report short‐ and long‐ term outcomes on neonates’ and infants’ data captured by different local, regional, national and international datasets that are available to us.

With the most vulnerable patient in mind (the premature infant or critically ill neonate), we are committed to translating scientific evidence into practical guidelines and establishing new therapies and treatment standards for the ultimate goal of improving the lives of our patients.

Peer-reviewed publications 2020-2021:

  1. Billimoria ZC, Rintoul NE, Sullivan KM, Hamrick SE, Chapman R, Mietzsch U, Keene S, Massaro AN, Seabrook RB, DiGeronimo RJ. Noninvasive neurocritical care monitoring for neonates on extracorporeal membrane oxygenation: where do we stand? J Perinatol. 2020 Aug 4; PMID: 32753710.
  2. Bosque EM. Development of an Alarm Algorithm, With Nanotechnology Multimodal Sensor, to Predict Impending Infusion Failure and Improve Safety of Peripheral Intravenous Catheters in Neonates. Adv Neonatal Care. 2020;20(3):233‐243.
  3. Umoren RA, Gray MM, Handley S, Johnson N, Kunimura C, Mietzsch U, Billimoria Z, Lo MD. In‐ Hospital Telehealth Supports Care for Neonatal Patients in Strict Isolation. American Journal of Perinatology. 2020 Apr 8.
  4. Freed AS, Clowes Candadai SV, Sikes MC, Thies J, Byers HM, Dines JN, Ndugga‐Kabuye MK, Smith MB, Fogus K, Mefford HC, Lam C, Adam MP, Sun A, McGuire JK, DiGeronimo R, Dipple KM, Deutsch GH, Billimoria ZC, Bennett JT. The Impact of Rapid Exome Sequencing on Medical Management of Critically Ill Children. J Pediatr. 2020 Jun 15; PMID: 32553838.
  5. Fry JT, Matoba N, Datta A, DiGeronimo R, Coghill CH, Natarajan G, Brozanski B, Leuthner SR, Niehaus JZ, Schlegel AB, Shah A, Zaniletti I, Bartman T, Murthy K, Sullivan KM; Children's Hospital Neonatal Consortium (CHNC). Center, Gestational Age, and Race Impact End‐of‐Life Care Practices at Regional NICU. J Pediatr. 2020 Feb;217:86‐91.e1. doi: 10.1016/j.jpeds. 2019.10.039. Epub 2019 Dec 9. PMID: 31831163
  6. Goldin AB, Raval MV, Thurm CW, Hall M, Billimoria Z, Juul S, Berman L. The Resource Utilization Inflection Point for Safe NICU Discharge. Pediatrics. 2020 Aug;146(2). doi: 10.1542/peds.2019‐ 3708. PubMed PMID: 32699067.
  7. Legocki AT, Zepeda EM, Gillette TB, Grant LE, Shariff A, Touch P, Lee AY, Ding L, Estrada MM, Tarczy‐Hornoch K, Lee CS, Mayock DE, Pepple KL, Cabrera MT. Vitreous findings by handheld spectral domain optical coherence tomography correlate with retinopathy of prematurity severity. Online ahead of print. Ophthalmol Retina. 4/9/20. (PMID: 32446843).
  8. Puia‐Dumitrescu M, Younge N, Benjamin DK, Lawson K, Hume C, Hill K, Mengistu J, Wilson A, Zimmerman KO,Ahmad K, Greenberg RG. Medications and in‐hospital outcomes in infants born at 22‐24 weeks gestation. J Perinatol. 2020 Feb 17. PMID: 32066843
  9. Starr M, Boohaker L, Eldredge LC, Menon S, Griffin R, Mayock D, Askenazi D, Hingorani S. Acute Kidney Injury is Associated with Poor Lung Outcomes in Infants Born ≥32 Weeks Gestational Age. Epub ahead of print 11/18/19. Am J Perinatol. 37:231‐240, 2020.(PMID: 31739364).
  10. Starr M, Boohaker L, Eldredge LC, Menon S, Griffin R, Mayock DE, Li L, Askenazi D, Hingorani S. Acute kidney injury and bronchopulmonary dysplasia in premature neonates born less than 32 weeks gestation. Am J Perinatol. 37:341‐348, 2020. (PMID: 31777046).
  11. Wild KT, Rintoul N, Kattan J, Gray B, Engle W, Keene S, Best D, Davis C, DiGeronimo R, Raman L. Extracorporeal Life Support Organization (ELSO): Guidelines for Neonatal Respiratory Failure. ASAIO Journal. 2020. DOI: 10.1097/MAT.0000000000001153. PMID: 32282347
  12. Agarwal P, Natarajan G, Sullivan K, Rao R, Rintoul N, Zaniletti I, Keene S, Mietzsch U, Massaro AN, Billimoria Z, Dirnberger D, Hamrick S, Seabrook RB, Weems MF, Cleary JP, Gray BW, DiGeronimo R. Venovenous versus venoarterial extracorporeal membrane oxygenation among infants with hypoxic‐ischemic encephalopathy: is there a difference in outcome?. J Perinatol. 2021 May 19. PMID: 34012056.
  13. Ost K, Oster NV, Jacobson EN, deHart MP, Englund JA, Hofstetter AM. Hepatitis B vaccination of low birth weight infants in Washington state. Am J Perinatol. 2020 Nov 30. DOI: 10.1055/s‐0040‐ 1721372.
  14. Rao R, Mietzsch U, DiGeronimo R, Hamrick SE, Dizon MLV, Lee KS, Natarajan G, Yanowitz TD, Peeples ES, Flibotte J, Wu TW, Zaniletti I, Mathur AM, Massaro A. Utilization of Therapeutic Hypothermia and Neurological Injury in Neonates with Mild Hypoxic‐Ischemic Encephalopathy: A Report from Children's Hospital Neonatal Consortium. Am J Perinatol. 2020 Sep 6. doi: 10.1055/s‐0040‐1716341. Online ahead of print. PMID: 32892328
  15. Peeples ES, Rao R, Dizon MLV, Johnson YR, Joe P, Flibotte J, Hossain T, Smith D, Hamrick S,
  16. DiGeronimo R, Natarajan G, Lee KS, Yanowitz TD, Mietzsch U, Wu TW, Maitre NL, Pallotto EK, Speziale M, Mathur AM, Zaniletti I, Massaro A; Children’s Hospitals Neonatal Consortium Hypoxic‐Ischemic Encephalopathy Focus Group.Pediatrics. Predictive Models of Neurodevelopmental Outcomes After Neonatal Hypoxic‐Ischemic Encephalopathy. 2021 Feb;147(2):e2020022962. doi: 10.1542/peds.2020‐022962. Epub 2021 Jan 15.PMID: 33452064

  17. Leon RL, Krause KE, Sides RS, Koch MB, Trautman MS, Mietzsch U. Therapeutic Hypothermia in Transport Permits Earlier Treatment Regardless of Transfer Distance. Am J Perinatol. 2020 Oct 14. doi: 10.1055/s‐0040‐1718372. Online ahead of print. PMID: 33053593
  18. Brei BK, Neches S, Gray MM, Handley S, Castera M, Hedstrom A, D'Cruz R, Kolnik S, Strandjord T, Mietzsch U, Cooper C, Moore JM, Billimoria Z, Sawyer T, Umoren R. Telehealth Training During the COVID‐19 Pandemic: A Feasibility Study of Large Group Multiplatform Telesimulation Training. Telemed J E Health. 2020 Dec 30. doi: 10.1089/tmj.2020.0357. Online ahead of print.PMID: 33395364
  19. Riddle S, Haberman B, Miquel‐Verges F, Somme S, Sullivan K, Rajgarhia A, Zaniletti I, Jacobson E; Children’s Hospitals Neonatal Consortium’s Gastroschisis Focus Group. Gastroschisis with intestinal atresia leads to longer hospitalization and poor feeding outcomes. J Perinatol. 2021 Jun 21. DOI: 10.1038/s41372‐021‐01131‐5. Epub ahead of print. PMID: 34155327.
  20. Utria A, Wong M, Faino A, Jacobson E, Javid P. The role of feeding advancement strategy on length of stay and hospital costs in newborns with gastroschisis. J Pediatr Surg. 2021 Apr 19;S0022‐3468(21)00313‐4. DOI: 10.1016/j.pedsurg.2021.04.011. Epub ahead of print. PMID: 34020775.
  21. Zhao J, Cairo S, Tian Y, Lautz T, Berkelhamer S, Pizzuto M, Raval M, Rothstein D. Gastrostomy tube placement in neonates undergoing tracheostomy: An opportunity to coordinate care? Journal of Perinatology, 2020 June 1. PMID: 32483142.
  22. Sawyer T, Billimoria Z, Handley S, Smith K, Yalon L, Brogan TV, DiGeronimo R. Therapeutic Plasma Exchange in Neonatal Septic Shock: A Retrospective Cohort Study. Am J Perinatol. 2020 Jul;37(9):962‐969. doi: 10.1055/s‐0039‐1692184. Epub 2019 Jun 8. PMID: 31176309
  23. Motz P, Do J, Lam T, DiBlasi RM, Fang T, Kelly K, DiGeronimo R, Billimoria ZC. Decreasing radiographs in neonates through targeted quality improvement interventions. J Perinatol. 2020 Feb;40(2):330‐336. doi: 10.1038/s41372‐019‐0565‐9. Epub 2019 Dec 16. PMID: 31844185; PMCID: PMC7223959
  24. Saoud R, Locke D, Fry JT, Matoba N, Datta A, DiGeronimo R, Leuthner SR, Coghill CH, Natarajan G, Niehaus JZ, Schlegel AB, Weiner J, Dereddy N, Shah A, Sullivan KM; Children’s Hospitals Neonatal Consortium (CHNC). Withdrawal of artificial nutrition and hydration: a survey of level IV neonatal intensive care units. J Perinatol. 2021 Mar 23. doi: 10.1038/s41372‐021‐01011‐y. Epub ahead of print. PMID: 33758396
  25. Seabrook RB, Grover TR, Rintoul N, Weems M, Keene S, Brozanski B, DiGeronimo R, Haberman B, Hedrick H, Gien J, Ali N, Chapman R, Daniel J, Harrison HA, Johnson Y, Porta NFM, Uhing M, Zaniletti I, Murthy K; Children’s Hospitals Neonatal Consortium Congenital Diaphragmatic Hernia Focus Group. Treatment of pulmonary hypertension during initial hospitalization in a multicenter cohort of infants with congenital diaphragmatic hernia (CDH). J Perinatol. 2021 Mar 1. doi: 10.1038/s41372‐021‐00923‐z. Online ahead of print. PMID: 33649432
  26. Weems MF, Grover TR, Seabrook R, DiGeronimo R, Gien J, Keene S, Rintoul N, Daniel JM, Johnson Y, Guner Y, Zaniletti I, Murthy K; Children's Hospitals Neonatal Consortium Congenital Diaphragmatic Hernia Focus Group. Analgesia, Sedation, and Neuromuscular Blockade in Infants with Congenital Diaphragmatic Hernia. Am J Perinatol. 2021 May 27. doi: 10.1055/s‐0041‐ 1729877. Epub ahead of print. PMID: 34044457
  27. Acharya K, Leuthner SR, Zaniletti I, Niehaus JZ, Bishop CE, Coghill CH, Datta A, Dereddy N, DiGeronimo R, Jackson L, Ling CY, Matoba N, Natarajan G, Nayak SP, Schlegel AB, Seale J, Shah A, Weiner J, Williams HO, Wojcik MH, Fry JT, Sullivan K; Palliative Care and Ethics Focus Group of the Children’s Hospital Neonatal Consortium (CHNC). Medical and surgical interventions and outcomes for infants with trisomy 18 (T18) or trisomy 13 (T13) at children's hospitals neonatal intensive care units (NICUs). J Perinatol. 2021 Jul;41(7):1745‐1754. doi: 10.1038/s41372‐021‐ 01111‐9. Epub 2021 Jun 10. PMID: 34112961; PMCID: PMC8191443
  28. Hamrick SEG, Ball MK, Rajgarhia A, Johnson BA, DiGeronimo R, Levy PT; Children’s Hospital Neonatal Consortium (CHNC) Cardiac Focus Group. Integrated cardiac care models of neonates with congenital heart disease: the evolving role of the neonatologist. J Perinatol. 2021 Jul;41(7):1774‐1776. doi: 10.1038/s41372‐021‐01117‐3. Epub 2021 Jun 17. PMID: 34140645
  29. Ramaraj A, Jensen G, Rice‐Townsend S, DiGeronimo R, Yalon L, Stark R. Similar frequency of atrial perforation between atrial and bicaval dual lumen veno‐venous ECMO cannulas in a pediatric population. Perfusion. 2021 Jul 15:2676591211030767. doi: 10.1177/02676591211030767. Epub ahead of print. PMID: 34264146
  30. Yallapragada S, Savani RC, Mūnoz‐Blanco S, Lagatta JM, Truog WE, Porta NFM, Nelin LD, Zhang H, Vyas‐Read S, DiGeronimo R, Natarajan G, Wymore E, Haberman B, Machry J, Potoka K; Children’s Hospital Neonatal Consortium severe bronchopulmonary dysplasia subgroup, Murthy
  31. K. Qualitative indications for tracheostomy and chronic mechanical ventilation in patients with severe bronchopulmonary dysplasia. J Perinatol. 2021 Aug 4:1–7. doi: 10.1038/s41372‐021‐ 01165‐9. Epub ahead of print. PMID: 34349231; PMCID: PMC8331995

  32. Vyas‐Read S, Logan JW, Cuna AC, Machry J, Leeman KT, Rose RS, Mikhael M, Wymore E, Ibrahim JW, DiGeronimo RJ, Yallapragada S, Haberman BE, Padula MA, Porta NF, Murthy K, Nelin LD, Coghill CH, Zaniletti I, Savani RC, Truog W, Engle WA, Lagatta JM. A comparison of newer classifications of bronchopulmonary dysplasia: findings from the Children's Hospitals Neonatal Consortium Severe BPD Group. J Perinatol. 2021 Aug 5:1–7. doi: 10.1038/s41372‐021‐01178‐4. Epub ahead of print. PMID: 34354227; PMCID: PMC8340076
  33. Cuna A, Lagatta JM, Savani RC, Vyas‐Read S, Engle WA, Rose RS, DiGeronimo R, Logan JW, Mikhael M, Natarajan G, Truog WE, Kielt M, Murthy K, Zaniletti I, Lewis TR; Children's Hospitals Neonatal Consortium (CHNC) Severe BPD Focus Group. Association of time of first corticosteroid treatment with bronchopulmonary dysplasia in preterm infants. Pediatr Pulmonol. 2021 Aug 11. doi: 10.1002/ppul.25610. Epub ahead of print. PMID: 34379886

Chapters 2020-2021:

  1. Billimoria ZC, Brogan T. Evidence and management of rare presentations in neonatal ECMO. Extracorporeal Membrane Oxygenation: An Interdisciplinary Problem‐Based Learning Approach. (In press)
  2. Rios A, Shur N. Chapter 31. Specific Congenital Metabolic Diseases. Neonatology for Primary Care 2ND Edition, AAP publisher, Editor: Deborah E. Campbell MD

Invited presentations 2020-2021: 

  1. DiGeronimo R. “Neonatology, ECLS and Surgery”. The International Congenital Diaphragmatic Hernia Symposium. Houston TX, Feb 2020
  2. Umoren RA. “Neonatal Telemedicine”. Central Washington Hospital, Wenatchee, WA. June, 2020
  3. DiGeronimo R. “Routine Use of Neuromonitoring in Neonates on ECMO: What is the Evidence?” Extracorporeal Life Support Organization Annual Meeting, Virtual, Sept 2020
  4. DiGeronimo R. “ECMO Focus Group Update” Children’s Hospital Neonatal Consortium Annual Meeting, Virtual, October 2020
  5. DiGeronimo R. “ECMO: From Contraindication to Treatment Guideline. Controversies in Septic Shock” NeoHeart Virtual Webinar, December 2020

GLOBAL NEONATAL MEDICINE

Investigators: Maneesh Batra MD MPH, Sara Berkelhamer MD, Cyril Engmann MD, Anna Hedstrom MD, Krystle Perez MD MPH, Rachel Umoren MBBCh, MS, Gregory Valentine, MD MEd

Program Description:

We have a focus on improving neonatal outcomes globally. The majority of small and sick newborns are born in resource‐limited settings where there are significant barriers to optimizing neonatal care. Additionally, a significant proportion of newborns in these settings are at risk for not meeting their developmental potential. Our members have a focus on overcoming these barriers through various means: advocacy and policy changes at local, national, and international levels; development of low‐cost, innovative solutions to resource‐constraints; mentorship for trainees seeking global health educational opportunities; and research into the impact of health disparities and how resource‐allocation impacts both maternal and neonatal outcomes. In 2020, our group developed ALIGN (Advancing Learning and Innovation in Global Neonatology) to enhance collaboration among members both within and outside of our division. The goal is to facilitate and promote projects that focus on improving neonatal outcomes and health disparities both locally and worldwide.

Peer-reviewed publications 2020-2021.

  1. Maya Brasher, Gregory Valentine. Crossing Boundaries: Mentorship in Global Health. Pediatrics 2021 Jan 8:e2020002154. Doi: 10.1542/peds.2020‐002154. PMID: 33419868
  2. Butteris SM, Leyenaar JK, Leslie LK, Turner AL, Batra M, on behalf of the Global Health Task Force of the American Board of Pediatrics. “International Experience of US Pediatricians and Comfort Caring for Vulnerable Populations.” J Peds. 2020 Jun 14. PMID:32553863.
  3. Crouse HL, Watts J, St Clair NE, Batra M, McGuinness G, Keating EM, Russ CM, Farr KM, Steenhoff AP, Schubert CJ, Leslie LK, Woods SK, Wilson KA, Camp EA, Butteris SM. “Global Health Opportunities in Pediatric Fellowships.” Pediatrics. 2020 Feb;145(2). PMID:32001489
  4. Hedstrom A, Faino AV, Batra M. “The Silverman Andersen respiratory severity score in the delivery room predicts subsequent intubation in very preterm neonates.” Acta Paediatr. 2020 Nov18. Online ahead of print. PMID:33210325.
  5. Hedstrom A, Faino AV, Batra M. “Utility of lung ultrasound and respiratory severity score for detection of respiratory distress syndrome in the delivery room.” Acta Paediatr. 2021 May;110(5):1683. PMID:33382117.
  6. Kasali B, Gururaja A, Batra M. “Newborn care technology investments for LMIC settings: a CPAP approach.” BMJ Innovations. Online First: 07 April 2021.
  7. Lauden SM, Wilson PM, Faust MM, Webber S, Schwartz A, Mahan JD, Batra M, Schubert CJ, on behalf of the Pediatric Resident Burnout‐Resilience Study Consortium. “Global Health Experiences, Well‐being, and Burnout: Findings from a National Longitudinal Study.” Acad Peds. 2020 May 11. PMID:32437879.
  8. Rent S, Winter J, Umoren R, Vaucher Y, Nelson B, St Clair N, Bose C, Ehret D. Recent interest in global health among American Academy of Pediatrics Newborn Specialists. Journal of Perinatology. 2020 Nov. https://doi.org/10.1038/s41372‐020‐00869‐8
  9. Rose Sulentic, Maxim Seferovic, Kjersti Aagaard, Gregory Valentine. Perinatal COVID‐19 Outcomes: Evaluating the Strength of Current Evidence. Journal of Maternal‐Fetal & Neonatal Medicine. 2020 Nov 29:1‐7 Doi:10.1080/14767058.2020.1849101. PMID: 33249963
  10. Russ C, Barnes A, Condurache T, Haq H, Keating E, Morris L, Watts J, Batra, M. “Development of the APPD Global Educator Scholarship – Expanding Bidirectional Efforts in Global Health Education.” Academic Pediatrics. Online First 2021 May 5:S1876‐2859(21)00250‐3. PMID: 33964475.
  11. Setty SG, Batra M, Hedstrom AB. “The Silverman Andersen respiratory severity score can be simplified and still predicts increased neonatal respiratory support.” Acta Paediatr. 2020 Jun;109(6):1273‐1275. PMID:31867755 .
  12. Gregory Valentine, Rachel Umoren, Krystle Perez. Early Inadequate or Excessive Weight Loss: A Potential Contributor to Mortality in Premature Newborns in Resource‐Scarce Settings? Pediatrics and Neonatology. 2021 Jan 23:S1875‐9572(21)00005‐X. doi: 10.1016/j.pedneo.2021.01.004. PMID: 33678594
  13. Gregory Valentine, Msandeni Chiume, Joseph Hagan, Peter Kazembe, Kjersti Aagaard, Monika Patil. Neonatal mortality rates in the neonatal intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi. Early Human Development. 2020 Aug 19;151:105158. doi:10.1016/j.earlhumdev.2020.105158. PMID: 32871453
  14. Rent S, Valentine G, Ehret D, Kukora S. Global health traininig during neonatal fellowship: fellow and proogram director perspectives. J Perinatol. 2020 Aug;40(8):1253‐1261. Doi: 10.1038/s41372‐020‐0639‐8. PMID: 32152489
  15. Gregory Valentine, Krystle Perez, Elliott Weiss. Community empowerment through education: the inherent foundation of promoting solidarity in global health research. American Journal of Bioethics. 2020. Jun;20(5):77‐79. doi: 10.1080/15265161.2020.1745941. PMID: 32364481
  16. Zelasko J, Omotayo MO, Berkelhamer SK, Niermeyer S, Kak L, Kumar S, Ram PK. Neonatal Oxygen Therapy in Low and Low‐Middle Income Countries: A Pragmatic Review. J Global Health Reports, 2020.
  17. Ashish KC, Berkelhamer S, Gurung R, Hong Z, Wang H, Sunny AK, Bhattarai P, Poudel PG, Litorp H. The burden of and factors associated with misclassification of intrapartum stillbirth: evidence from a large scale multi‐centric observational study. Acta Obstet Gynecol Scand. March 2020, 99(3). PMID: 31600823.
  18. Gurung R, Litorp H, Berkelhamer S, Zhou H, Tinkari BS, Paudel P, Malla H, Sharma S, Ashish KC. The burden of misclassification of antepartum stillbirth in Nepal. BMJ Global Health, 2019 Dec 11; 4(6). PMID: 31908870.
  19. Sunny A, Paudel P, Tiwari J, Bagale B, Kukka A, Hong Z, Ewald U, Berkelhamer S, KC A. A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal, BMC Pediatrics, 2021 in pre
 

Chapters 2020-2021:

  1. Valentine G, Hair A, Martin C. Microbiome and Pediatric Obesity, Malnutrition, and Nutrition. The Developing Microbiome: Lessons from Early Life. 2020.

Invited presentations 2020-2021:

  1. Batra M. “Towards building an equitable resident educational global health partnership: Lessons during COVID‐19 pandemic with the ‘Resident Education and Advocacy for Child Health Program’ at the Universities of Nairobi and Washington.” State of the Art Plenary Speaker, Pediatric Academic Societies Annual Meeting, Held Virtually due to COVID‐19, April 2021.
  2. Batra M. “Finding a Niche in Global Neonatal Health.” Johns Hopkins University School of Medicine Neonatology Clinical Conference Series.
  3. Riddle S, Karpen H, Sullivan K, Zaniletti I, Jacobson E, on behalf of CHNC Gastroschisis Focus Group. Gastroschisis and low incidence of early inset infection: a case for antimicrobial stewardship? Accepted for presentation at Pediatric Academic Societies, 2020; Poster (meeting canceled).
  4. Ost K, Oster N, Jacobson EN, deHart MP, Englund JA, Hofstetter AM. Hepatitis B vaccination of infants weighing <2000g in Washington state. Accepted for presentation at Pediatric Academic Societies, 2020; Poster (meeting canceled).
  5. Kenningham K, Billimoria Z, Dutta M, Baker C, Jacobson E, DiGeronimo R. Effect of team structure and intake call process mapping on transport team mobilization time. American Academy of Pediatrics 2020 National Conference (meeting changed to virtual).
  6. Utria AF, Wong M, Faino A, Jacobson EN, Deam N, Javid PJ. Shortening time to goal feeds decreases length of stay and hospital costs in gastroschisis. American Academy of Pediatrics 2020 National Conference (meeting changed to virtual).
  7. Riddle S, Karpen H, Sullivan K, Zaniletti I, Jacobson E, on behalf of CHNC Gastroschisis Focus Group. Gastroschisis and low incidence of early onset infection: a case for antimicrobial stewardship? Accepted for presentation at Pediatric Academic Societies Virtual Meeting, Phase 1, 2021; e‐Poster with Chat Q&A.
  8. Riddle S, Acharya K, Ahmad I, Agarwal N, Bendel‐Stenzel E, Karpen H, Shepherd J, Williams S, Zaniletti I, Jacobson E, on behalf of CHNC Gastroschisis Focus Group. Gestational age at delivery and neonatal outcomes among infants with gastroschisis in the Children’s Hospital Neonatal Consortium. Accepted for presentation at Pediatric Academic Societies Virtual Meeting, Phase 1, 2021; e‐Poster with Chat Q&A.
  9. Hofstetter A, Chaudhary R, Buchmeier R, Ost K, Jacobson E, Englund J. Parental knowledge, attitudes, and experiences regarding vaccination of children born prematurely. Accepted for presentation Pediatric Academic Societies Virtual Meeting, Phase 1, 2021; Highlighted e‐Poster with Live Q&A. Bolte E, Seferovic M, Valentine G, Jochum M, Chu D, Pace R, Fowler S, Swennes S, Versalovic J, Aagaard A. Maternal microbial conventionalization fails to normalize Zika Virus transmission compared to conventional mouse. Society for Maternal Fetal Medicine Conference. Grapevine, Texas. February 2020
  10. Bolte B, Seferovic S, Valentine G, Jochum M, Prince A, Chu D, Pace R, Fowler S, Swennes A, Versalovic J, Aagaard K. Maternal microbial conventionalization alters type I interferon signaling in mice. Society for Maternal Fetal Medicine Conference. Grapevine, Texas. February 2020.
  11. Cerdena J, Oyewole V, Welty S, Valentine G. Prevention of neonatal refeeding syndrome with implementation of a novel parenteral nutrition regimen. Pediatric Academic Societies. May 2020 (Accepted for platform presentation, but PAS cancelled due to COVID‐19)
  12. Valentine G, Chiume M, Hagan J, Kazembe P, Aagaard K, Patil M. Maternal administration of antenatal corticosteroids associated with improved neonatal mortality in Lilongwe, Malawi. Society for Maternal Fetal Medicine Conference. Grapevine, Texas. February 2020
  13. Valentine G, Chiume M, Hagan J, Kazembe P, Aagaard K, Patil M. Neonatal mortality rates in the neonatal intensive care unit at Kamuzu Central Hospital in Malawi. Society for Maternal Fetal Medicine Conference. Grapevine, Texas. February 2020.
  14. Valentine G, Chiume C, Hagan J, Kazembe P, Aagaard K, Patil M. Maternal administration of antenatal corticosteroids associated with improved neonatal mortality in Lilongwe, Malawi. Pediatric Academic Societies. May 2020 (Accepted for platform presentation, but PAS cancelled due to COVID‐19)
  15. Valentine G, Chiume M, Hagan J, Kazembe P, Aagaard K, Patil M. Neonatal mortality rates in the neonatal intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi. Pediatric Academic Societies. May 2020 (Accepted for poster presentation, but PAS cancelled due to COVID‐19)
  16. Valentine G. Low‐cost, limited‐electricity IV fluid infusion device to prevent neonatal dehydration. Mar 2020. Seattle Children’s Hospital Global Health Career Development Group
  17. Valentine G. COVID‐19 and Newborn Care: Resource‐Limited Settings. July 2020. UNICEF and AAP
  18. Valentine G. Prevention of prematurity and xylitol study. March 2020. Baylor‐Malawi Children’s Foundation in Lilongwe, Malawi
  19. Umoren RA. Do Virtual Reality Tools Improve Healthcare Workers Skills Retention? Bill and Melinda Gates Foundation “Lunch and Learn” series. Online. August 11, 2020.
  20. Umoren RA. Development and Evaluation of Virtual Reality Simulations in Resource‐Scarce Settings. Open Simulator Community Conference. Online. December 6, 2020.

NEONATAL ETHICS AND PARENTAL DECISION-MAKING

Investigators: Elliott Weiss MD, MSME, Craig Jackson, MD

Program Description:

Ethical issues are frequently encountered by neonatologists. Our group examines how parents make medical decisions when their infant is in the NICU. Utilizing qualitative and quantitative methods, we aim to gain a deeper understand of how parents make medical decisions in the emotion‐laden, high‐stakes, and complex medical reality that often surrounds a seriously ill infant. Other areas of interest include clinical informed consent, research ethics and diversity in research populations, ethics at the limits of viability, and resource allocation in times of scarcity.

Peer-reviewed publications 2020-2021.

  1. Krick JA, Weiss EM, Snyder A, Haldar S, Campelia GD, Opel DJ. Living with the Unknown: A Qualitative Study of Parental Experience of Prognostic Uncertainty in the Neonatal Intensive Care Unit. Am J Perinatol 2020; epub ahead of print. PMID: 31899927
  2. Neubauer K, Williams EP, Donohue PK, Weiss EM, Lewis‐Newby M, Boss RD. Diagnosis to death: family experiences of paediatric heart disease. Cardiol Young 2020; 30(11): 1672‐1678. PMID: 32829727
  3. Boss RD, Henderson CM, Weiss EM, Falck A, Madrigal V, Shapiro MC, Williams EP, Donohue PK; Pediatric Chronic Critical Illness Collaborative. The Changing Landscape in Pediatric Hospitals: AMulticenter Study of How Pediatric Chronic Critical Illness Impacts NICU Throughput. Am J Perinatol 2020; epub ahead of print. PMID: 33075841
  4. Weiss EM, Wightman A, Webster L, Diekema DS. Conflicts of Interest in Clinical Ethics Consults. J Med Ethics 2020; epub ahead of print. PMID: 33443116
  5. Weiss EM, Olszewski AE, Guttmann KF, Magnus BE, Li S, Shah AN, Juul SE, Wu YW, Ahmad KA, Bendel‐Stenzel E, Isaza NA, Lampland AL, Mathur AM, Rao R, Riley D, Russell DG, Salih ZNI, Torr CB, Weitkamp JH, Anani UE, Chang T, Dudley J, Flibotte J, Havrilla EM, Kathen CM, O'Kane AC, Perez K, Stanley BJ, Wilfond BS, Shah SK. “Parental Factors Associated with the Decision to Participate in a Neonatal Clinical Trial.” JAMA Network Open 2021. 4(1): p. e2032106.
  6. Bogetz J, Weiss EM, Opel D. Use of Cognitive Shortcuts in Decision‐Making for Children with Severe Neurological Impairment. Pediatrics 2021; 147(3):e20200930. PMID: 33574161
  7. Miller DE, Wright J, Bly RA, Weiss EM, Susarla S, Wenger T. “Case 2: Seizures in a Neonate” NeoReviews 2021; 22(5) e335‐e338. PMID: 33931479
  8. Weiss EM, Kukora S, Barrington KJ. “Use of Composite NICU Research Outcomes for Goals of Care Counseling Creates Ethical Challenges” Acta Paediatrica 2021; epub ahead of print; PMID: 34214207

Other publications 2020-2021:

  1. Guttman KF, Wu YW, Juul SE, Weiss EM. Consent related challenges for neonatal clinical trials. American Journal of Bioethics. 20 (5) 38‐40, 2020.
  2. Valentine GC, Perez K, Weiss EM. Community Empowerment Through Education: The Inherent Foundation of Promoting Solidarity in Global Health Research. Am J Bioeth 2020; 20(5): 77‐79. PMID: 32364481
  3. Olszewski AE, Scott M, Patneaude A, Weiss EM, Wightman A. Race and Power at the Bedside: Counter Storytelling in Clinical Ethics Consultation. Am J Bioeth 2021; 21(2): 77‐79. PMID: 33534694
  4. Porter KM, Weiss EM, Kraft SA. Promoting Disclosure and Understanding in Informed Consent: Optimizing the Impact of the Common Rule “Key Information” Am J Bioethics 2021; 21(5): 70‐72. PMID: 33945415

 Chapters 2020-2021: 

  1. Cheng EY, Jackson JC. Prenatal Diagnosis and Counseling. In Avery’s Diseases of the Newborn, 11th Edition, ed. Gleason & Sawyer (In Press).

Invited presentations 2020-2021: 

  1. Weiss EM. “Neonatal Clinical Trial Enrollment: Challenges, Successes, and Lessons from a Large Randomized Controlled Trial” Dr. Gregory Mantych Visiting Professors & Pediatrics Grand Rounds, Department of Pediatrics, St. Louis University, St. Louis, MO, April 2020
  2. Weiss EM. “How Can We Optimize Neonatal Clinical Trial Enrollment? Challenges, Successes and Possibilities” Pediatrics Grand Rounds, Department of Pediatrics, University of Washington, Seattle, WA, January 2021
  3. Weiss EM. “Neonatologist/Ethicist 4.5 Years Out of CHOP Fellowship” Neonatology Fellowship Didactics, Children’s Hospital of Philadelphia, Philadelphia, PA, March 2021
  4. Weiss EM. “Conflicts of Interest in Clinical Ethics Consultation.” Invited speaker, Madigan Army Medical Center Ethics Forum, Joint Base Lewis‐McChord, WA, April 2021
  5. Weiss EM. “Participation in Neonatal Clinical Trials: Successes, Challenges, and Future Possibilities” Child Health Research Seminar Series, Department of Pediatrics, Mount Sinai, and Mindich Child Health and Development Institute, New York, NY, May 2021

NEONATAL PULMONARY PHYSIOLOGY

Investigators: Sara Berkelhamer, MD

Program Description:

The complex physiology of premature and newborn infants represent an area of great interest in optimizing outcomes. Despite notable progress in both survival and associated morbidity with premature birth, limited progress has been made in reducing rates of bronchopulmonary dysplasia. Research in translation models of pulmonary disease provide insight into basic mechanisms and optimal management of disease. Novel work in resuscitation models influences resuscitation algorithms at birth.

Peer-reviewed publications 2020-2021.

  1. Zhang L, Soni S, Hekimuglu E, Berkelhamer S, Cataltepe S. Impaired autophagic activity in the pathogenesis of bronchopulmonary dysplasia. American Journal of Respiratory Cell and Molecular Biology, 2020 May 6. PMID: 32374619.
  2. Singh AP, Chandrasekharan P, Gugino S, Berkelhamer S, Wang H, Nielsen L, Kumar VHS. Effects of Neonatal Caffeine Administration on Vessel Reactivity in Adult Mice. Am J Perinatology. 2020 June 2. PMID: 32485758.
  3. Nair J, Davidson L, Gugino S, Koenigsknecht C, Helman J, Nielsen L, Sankaran S, Agrawal V, Chandrasekharan P, Rawat P, Berkelhamer S, Lakshminrusimha S. Sustained Inflation Reduces Pulmonary Blood Flow During Resuscitation with an Intact Cord, Children, Apr 29;8(5):353. PMID 33946658.

Invited presentations 2020-2021:

  1. Berkelhamer, S. Developmental Susceptibility to Oxidative Lung Injury, University of Alabama Neonatal Research Seminar, January, 2020

 

Research Program and Lab Websites

Training Programs
Training Programs

Neonatal-Perinatal Fellowship Training Program

Megan Gray, MD, Program Director; Kirti Upadhyay, MD, Associate Program Director

The Neonatal‐Perinatal Medicine Fellowship Training Program at the University of Washington began in the mid‐1960s. Our mission is to educate and inspire the next generation of neonatologists who will provide state‐of‐the‐art, evidence‐based clinical care, and to assist and mentor them in finding and pursuing their scholarly passion so they are poised to be the future academic leaders of our field. During their 3 years of training, fellows' complete NICU rotations in the two teaching hospitals (Seattle Children's Hospital & University of Washington Medical Center); as well as rotation in Perinatology, Cardiac ICU, Pediatric Surgery; and also in one of the Division's community hospital NICUs. Fellows also attend NICU follow‐up clinic. Additionally, fellows achieve a high degree of scholarly/ academic competence in order to excel in a career in academic neonatology. We have designed our program to provide ample protected time for scholarly activities. Our research areas of focus include neuroscience, global health, education/simulation, quality improvement, and biomedical ethics. We have strong research mentors both within and outside the Neonatology Division. Please read more about our fellowship at our Neonatal-Perinatal Fellowship webpage.

Prior Fellowship Graduates:

Graduate Training Years
Rushahb Shah 2019-2022
Ben al-Haddad 2019-2022
Sarah Kolnik  2018-2021
Katherine Kenningham 2018-2021
Brianna Brei 2017-2020
Shubha Setty  2017-2020
Teresa Lam 2016-2019
Patrick Motz 2016-2019
Meenakshi Dutta 2015-2018 
Kendell German 2015-2018 
Jeannie Krick  2015-2018   
Gillian Pet 2014-2017 
Anita Shah 2014-2017
Eric Peeples 2013-2016 
Jayalakshmi (Ammu) Ravindran 2013-2016
Shaun Odell 2012-2015
Vijayeta (Vij) Rangarajan 2012-2015
Anna Hedstrom 2011-2014
Stacey Soileau 2011-2014
Pattaraporn Tanya Chun 2010-2013
Rachel Fleishman 2010-2013
Andrew Beckstrom 2008-2011
Elizabeth Jacobson 2008-2011
Annie Nguyen-Vermillion 2007-2010
Janna Patterson 2007-2010
Jessica Slusarski 2006-2009
Marcella Mascher-Denen 2005-2008
Maneesh Batra 2004-2007
Katherine Salinas/Simon 2004-2006
Susan Miller 2002-2005
Robert Mertz 2002-2005
Eric Demers 2002-2005
David Anderson 2000-2003
Michael Neufeld 1999-2003
Eric Leung 1999-2003
Valerie Newman 1993-1994
Peter Tarczy-Hornoch 1992-1995
James Berger 1990-1993
Matt Lee 1989-1992
Thomas Strandjord 1987-1990
Charles Davis 1987-1989
Sandra Juul 1986-1989
Gary Twiggs 1985-1987
A.C. Hoffmeister 1985-1987
Jon Watchko 1983-1986
J. Craig Jackson 1982-1985
Richard Badura 1982-1985
Greg Sorensen 1982-1984
Dennis Mayock 1979-1981
Kelly Wright 1979-1981
William E. Truog 1976-1978
Dale Kessler 1976-1978
Charles Haberkern 1975-1977
Robert Perelman 1975-1977
Robert Guthrie 1974-1976
Jonelle Rowe 1974-1976
David Belenky 1973-1975
John Prueitt 1973-1975
Paul Hinkes 1973-1975
John Yount 1973-1975
Jacquelyn Bamman 1972-1974
Janet Murphy 1972-1974
Thomas Nelson 1971-1973
Rosemary Orr 1971-1973
Errol Alden 1970-1972
David Woodrum 1969-1971
Colby Parks 1969-1971
Ron Bloom 1969-1971
Robert Hall 1968-1970
Thomas Helmrath 1967-1969
Richard Wennberg 1966-1968
 

Resident Education

Maneesh Batra, MD, MPH, Associate Director, Pediatric Residency Program

Our faculty, fellows, and advanced neonatal practitioners are involved in several aspects of the core training program for pediatric residents. Currently the University of Washington Pediatric Residency Program accepts 45 residents per year. All residents complete one 4‐week rotation in the UWMC NICU during their intern year and one or more rotations in the UWMC NICU and SCH NICU over the course of their subsequent 2 years of residency. For all of these trainees our faculty, fellows and advance neonatal practitioners provide bedside teaching during the rotation. Additionally, our Division has been responsible for training all pediatric interns in the Newborn Resuscitation Program (NRP). Several of our faculty are invited to participate each year in the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) visiting professor program. Our neonatologists and neonatal APPs are involved in the training of Family Practice residents at several of our clinical sites.

Medical Student Education

Kirti Upadhyay, Course Director

An elective rotation in the UWMC NICU is offered to 4th year medical students. Division faculty also lecture in various medical school courses (for example, Ethics) and offer research experience for students in their laboratories. In addition, selected faculty have participated in the University of Washington’s medical school “College Faculty” program.

Advanced Practice Provider Training

Elena Bosque, PhD, NNP, Neonatal Program Development

We have developed a two‐pronged approach to grow the neonatal advanced practice provider (APP) staff in our many hospitals:

Neonatal Physician Assistant (PA) Fellowship Program: A 12‐month neonatal PA fellowship program included clinical training and weekly didactics. Case‐based presentations were provided by neonatal APPs, neonatologists, and allied professionals.

New Graduate Nurse Practitioner (NNP) Orientation Program: The new graduate NNP program included clinical training and monthly meetings with peer support, lectures, and case presentations. For both programs, neonatal APP’s are clinical mentors. Team‐building activities supported mentorship and collaboration among all care providers.

In addition, the SCH NNPs train NNP students from long‐distance Masters/Doctorate in Nursing Practice NNP Programs from around the country.

Neonatal Advanced Practice Provider Accomplishments 2020‐2021

Over 50 neonatal SCH APPs provide mid‐level care in seven Level II‐IV NICUs in the region, in collaboration with UW/SCH neonatologists. They support the training of UW pediatric residents and family practice residents in the region, educate nurses, participate in quality improvement projects and champion research.

Continuing Faculty Education

Division

  • Weekly UWMC and community sites BPD team conference
  • Weekly Tuesday fellows’ clinical conference/board review for fellows and faculty
  • Weekly Tuesday conference, rotating agenda for clinical, research, education, business topics
  • Monthly Tuesday Neonatology/Surgery clinical conference
  • Weekly Wednesday bedside SCH NICU clinical conference with pediatric surgeons
  • Wednesday bedside SCH Neurosurgery teaching rounds
  • Weekly Thursday SCH BPD team conference
  • Weekly Friday prenatal genetics and imaging conference
  • Weekly Friday research conference
  • Weekly Friday SCH Neuro‐NICU conference
  • Monday and Friday SCH NICU Radiology teaching conference
  • Monthly Friday SCH Neonatal Neuroradiology Conference

Department

  • Weekly Wednesday Department of OB/GYN Grand Rounds
  • Weekly Wednesday Department of Medicine Grand Rounds
  • Weekly Thursday Department of OB/GYN Grand Rounds
Interim Division Chief

Maneesh Batra, MD, MPH

Professor of Pediatrics, Adjunct Professor of Global Health

Faculty

Maneesh Batra, MD, MPH

Professor of Pediatrics, Adjunct Professor of Global Health

Sara Berkelhamer, MD

Associate Professor of Pediatrics

Zeenia C Billimoria, MD

Associate Professor of Pediatrics Medical Director, NICU, Seattle Children’s Hospital Associate Medical Director, Neonatal Transport Program, Seattle Children’s Hospital Co‐lead, Seattle Children’s NICU Quality Improvement Microsystem

Shilpi Chabra, MD

Professor of Pediatrics

Toby L Cohen, MD

Professor of Pediatrics Associate Medical Director, UW Valley Medical Center

Robert J DiGeronimo, MD

Clinical Professor of Pediatrics Medical Director, Neonatal Transport and Extracorporeal Life Support Programs, Seattle Children’s Hospital Co‐Director of Congenital Diaphragmatic Hernia Program, Seattle Children’s Hospital

Meenakshi Dutta, MD

Clinical Assistant Professor of Pediatrics

Cyril M Engmann, MD

Clinical Professor of Pediatrics and Global Health Senior Director, Program and Impact & Institutional Official, PATH

Kendell R German, MD

Assistant Professor of Pediatrics Director of Research, Infant Development Follow‐Up Clinic Associate Medical Director, Neonatal-Perinatal Medicine Fellowship

Megan Mariner Gray, MD

Associate Professor of Pediatrics Fellowship Program Director Associate Division Head of Education Director of Research, NEST Program

Sarah J Handley, MD

Clinical Associate Professor of Pediatrics Associate Medical Director, NICU at Seattle Children's NEST Associate Director of Outreach Education Director of The Bronchopulmonary Dysplasia Team, Seattle Children’s Hospital

Anna Bruett Hedstrom, MD

Associate Professor of Pediatrics

Craig Jackson, MD, MHA

Professor of Pediatrics

Elizabeth N. Jacobson, MD

Clinical Associate Professor of Pediatrics, Division of Neonatology Quality and Safety Medical Director, Neonatology Regional Network Site Physician Sponsor, Children’s Hospital Neonatal Consortium, Seattle Children’s Hospital

Sandra Juul, MD, PhD

Professor of Pediatrics, Adjunct Professor of Neuroscience Associate Director, CHDD Strategic Planning Committee

Sarah Kolnik, MD, MBA

Assistant Professor

Robin LaGrandeur, MD

Clinical Assistant Professor of Pediatrics Associate Medical Director, NICU, St Joseph Medical Center

Janessa Law, MD

Assistant Professor of Pediatrics Director – BRAIN Team

Christina M Long, DO

Clinical Professor of Pediatrics Medical Director, NICU, Valley Medical Center Chair, Department of Pediatrics, Valley Medical Center

Dennis E. Mayock, MD

Professor of Pediatrics

Ulrike Mietzsch, MD

Clinical Associate Professor of Pediatrics Medical Director, Neuro‐NICU, Seattle Children’s Hospital

Michael D. Neufeld, MD, MPH

Clinical Professor of Pediatrics Medical Director, NICU, Providence Regional Medical Center Everett

Krystle Perez, MD, MPH

Assistant Professor of Pediatrics Associate Program Director, Pediatric Residency Program Adjunct Assistant Professor of Global Health Director of The Bronchopulmonary Dysplasia Team, UWMC NICU

Jose Perez, MD, MBA

Clinical Professor of Pediatrics Co‐Director of the Regional Neonatal Outreach Program Associate Division Head, Clinical Operations

Mihai Puia-Dumitrescu, MD, MPH, CMQ

Assistant Professor of Pediatrics Director of Clinical Research, Division of Neonatology Associate Medical Director, NICU at Seattle Children's

Angel Rios, MD

Clinical Professor of Pediatrics Pediatric Section Head, NICU, University of Washington‐Northwest Campus

Taylor L Sawyer, DO, MEd, MBA

Professor of Pediatrics Director of Medical Simulation, Seattle Children's Hospital Associate Vice Chair for Regional Medicine, Department of Pediatrics Director of Outreach Education, Neonatal Education & Simulation Based Training (NEST) Program

Andy Shih, PhD

Associate Professor of Pediatrics Principal Investigator at the Shih Lab at Seattle Children’s Research Institute

Kendra Smith, MD

Clinical Professor of Pediatrics

Thomas P. Strandjord, MD

Clinical Professor of Pediatrics Associate Medical Director, NICU, University of Washington Medical Center Associate Medical Director, NICU, Northwest Hospital

David Taylor Hendrixson, MD

Assistant Professor

Rachel A Umoren, MB, ChB, MS

Associate Professor of Pediatrics Director, Neonatal Education and Simulation Training (NEST) Program Neonatal Telemedicine Lead Associate Division Head, Research Medical Director, Inpatient Telehealth Services, SCH

Kirti Upadhyay, MD

Medical Director, University of Wasington Medical Center NICU Clinical Associate Professor of Pediatrics Director of Quality, Division of Neonatology NICU Clerkship Director, UW Medical Center

Gregory Charles Valentine, MD, MEd

Assistant Professor of Pediatrics Adjunct Assistant Professor in Obstetrics & Gynecology ‐ Baylor College of Medicine

Elliott Mark Weiss, MD, MSME

Associate Professor of Pediatrics Associate Professor, Division of Bioethics

Stephen E Welty, MD

Professor of Pediatrics Medical Director, NICU, St. Joseph’s Medical Center

Thomas Ragnar Wood, BM, BCh, PhD

Research Assistant Professor of Pediatrics

Staff

Tracy Anderson

ACGME Fellowship Program Coordinator

Megan Carlson

Administrative Assistant

Christine Cooper, DNP, ARNP, NNP-BC, MBA

Associate Director of Clinical Integration

Kylie A. Corry

Research Scientist

John Feltner, MS

Lead Research Coordinator

R. Neil Kline

Program Coordinator

Daniel Moralejo, PhD, DVM

Research Scientist Lab Manager

Ujiro Okiomah, MBA, FACMPE

Division Administrator

Rachelle Sigourney, MBA

Administrative Specialist

Contact Information
Contact Information

Box 356320, RR542 HSB
Seattle WA 98195-6320
Tel (206) 543-3200
Fax (206) 543-8926