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Watchful Waiting: The New Recommendation for Most Preterm Infants With PDA
 Watchful Waiting: The New Recommendation for Most Preterm Infants With PDA 1024 683 Abbie Miller
By: Abbie Miller

A study published in JAMA found that treating patent ductus arteriosus with medication did not help with disease management but was associated with higher mortality.   A new study from the Neonatal Research Network, published in JAMA, found that treating patent ductus arteriosus (PDA) in preterm infants with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen at…

Prematurity Increases Morbidity and Mortality Risk in Preterm Neonates with Down Syndrome in the NICU
 Prematurity Increases Morbidity and Mortality Risk in Preterm Neonates with Down Syndrome in the NICU 1024 624 JoAnna Pendergrass, DVM
By: JoAnna Pendergrass, DVM

  Premature neonates with Down syndrome who are admitted to the neonatal intensive care unit experience higher rates of health complications and an increased mortality risk.   A retrospective study led by Emily Messick, DO, at Nationwide Children’s Hospital, reported the increased risk of adverse health outcomes in preterm neonates with Down syndrome in the…

Clinical Genomics: From Research to Reality
 Clinical Genomics: From Research to Reality 1024 716 Abbie Miller
By: Abbie Miller

Without genomic sequencing, many genetic diseases would never be diagnosed. Genomic testing — whole exome or whole genome sequencing — is vital to reducing the diagnostic odyssey for children with rare, undiagnosed disease. But is genetic analysis only useful in these cases? Experts across the country have long suggested that genomic testing can be even…

Genomics Testing in the Neonatal Intensive Care Unit: Reducing Variability, Improving Utility
 Genomics Testing in the Neonatal Intensive Care Unit: Reducing Variability, Improving Utility 1024 575 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Genomics testing of infants in the neonatal intensive care unit (NICU) has the potential to improve care, but process improvement efforts require consideration of major differences in hospital resources. Babies with genetic conditions make up a significant number of the infants in pediatric and neonatal intensive care units (NICUs), but knowing which babies are sick…

Meet Amy Brown Schlegel, MD, Section Chief of Neonatology
 Meet Amy Brown Schlegel, MD, Section Chief of Neonatology 1024 603 Pam Georgiana
By: Pam Georgiana

After over a decade in Neonatology at Nationwide Children’s Hospital, Dr. Schlegel has been appointed section chief of Neonatology. We recently sat down to talk with Dr. Schlegel about her time at Nationwide Children’s and her plans for leading the next phase of growth in Neonatal care. Amy Brown Schlegel, MD, practices Neonatology in the…

Updated Small Baby Care Guidelines Reflect 20 Years of Work Toward Improved Outcomes
 Updated Small Baby Care Guidelines Reflect 20 Years of Work Toward Improved Outcomes 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Thorough management guidelines for babies born before 27 weeks’ gestation join the program’s long list of accomplishments in improving survival and standardizing care for this vulnerable population. As the Small Baby Program at Nationwide Children’s Hospital celebrates its 20th anniversary, it is also releasing its latest set of care guidelines for their tiny patients. Divided…

Nephrotoxic-Associated Acute Kidney Injury (NAKI) Is Avoidable
 Nephrotoxic-Associated Acute Kidney Injury (NAKI) Is Avoidable 375 280 Pam Georgiana
By: Pam Georgiana

Quality improvement initiative at Nationwide Children’s Hospital leads to significant reductions in NAKI. Nephrotoxic-associated acute kidney injury (NAKI) — an under-recognized but serious risk in pediatric hospital care — affects up to 25% of hospitalized children. It occurs when medications or toxins reduce kidney function by disrupting blood flow, damaging renal cells or triggering inflammation.…

The Nurse Perception of Infant Condition (NPIC) Scale: A Tool for NICU Nurses to Evaluate Neonatal Well-being
 The Nurse Perception of Infant Condition (NPIC) Scale: A Tool for NICU Nurses to Evaluate Neonatal Well-being 1024 683 Jessica Nye, PhD
By: Jessica Nye, PhD
Baby in NICU

Investigators from Nationwide Children’s Hospital developed a tool for nurses to use when assessing a neonate’s wellbeing, called the Nurse Perception of Infant Condition (NPIC) Scale. “For neonates, it was hard to find a scale that was relevant and would allow us to measure anything for research,” says Christine A. Fortney, PhD, RN, FPCN, FAAN,…

Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk
 Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The RSS score is noninvasive and may be clinically useful for risk stratification in extremely preterm infants. Researchers at Nationwide Children’s report that elevations in the respiratory severity score were correlated with an increased risk of bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. This study identifies a pragmatic clinical risk score that can be measured…

What Are the Risk Factors for Recurrent Wheezing in Late Preterm Infants?
 What Are the Risk Factors for Recurrent Wheezing in Late Preterm Infants? 1024 683 Pam Georgiana
By: Pam Georgiana

A collaboration between a pulmonary medicine fellow and allergy and immunology expert identifies four risk factors associated with recurrent wheezing in these patients.   When Brooke R. Gustafson, MD, a member of the Section of Pediatric Pulmonary Medicine at Nationwide Children’s and an assistant professor of pediatrics at The Ohio State University College of Medicine,…

Expanding Access to Genomic Testing in Level IV Neonatal Intensive Care Units
 Expanding Access to Genomic Testing in Level IV Neonatal Intensive Care Units 1024 575 Pam Georgiana
By: Pam Georgiana
conceptual art of DNA

Recent study identifies variations in availability and highlights opportunities to improve access to genomic testing in the United States and Canada. In the Nationwide Children’s Hospital neonatal intensive care unit, patients needing rapid genome sequencing can get it on demand without administrative approval. However, that is not the case in all level IV neonatal intensive…

Kidney Support for Babies: Building a Comprehensive and Integrated Neonatal Kidney Support Therapy Program
 Kidney Support for Babies: Building a Comprehensive and Integrated Neonatal Kidney Support Therapy Program 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Kidney support therapy (KST), commonly referred to as dialysis, is a life-saving procedure used to manage complications associated with acute kidney injury and kidney failure, such as fluid overload and electrolyte imbalances, or to remove toxins, such as those in patients with inborn errors of metabolism. Most KST or dialysis machines are designed for adults…

Shorter Course of Antibiotics for Early Onset Sepsis as Safe as Longer Course
 Shorter Course of Antibiotics for Early Onset Sepsis as Safe as Longer Course 150 150 Jessica Nye, PhD
By: Jessica Nye, PhD

Discontinuing empirical antibiotic therapy for early-onset sepsis (EOS) at 24 hours had a similar safety profile as the standard 48-hour treatment course. “In the neonatal intensive care unit (NICU), we have data to show that each additional day of unnecessary antibiotics leads to adverse side effects, both short term while in the NICU and some…

Advancing Genomics-Driven Precision Medicine in the NICU
 Advancing Genomics-Driven Precision Medicine in the NICU 1024 683 Natalie Wilson
By: Natalie Wilson

According to the Children’s Hospitals Neonatal Consortium, as many as half of newborns hospitalized in level IV neonatal intensive care units (NICUs) due to critical illness have an underlying genetic condition. Most don’t get their diagnosis for months or even years. However, clinical assays, new testing modalities and clinical trials are improving their care. Advanced…

Using Machine Learning in the Electronic Medical Record to Save Lives
 Using Machine Learning in the Electronic Medical Record to Save Lives 1024 683 Abbie Miller
By: Abbie Miller
physicians in white coats looking at a tablet

The deterioration risk index identifies patients at risk for deterioration and poor outcomes, triggering the care team to act before a crisis happens. In a report published in Pediatric Critical Care Medicine, a team from Nationwide Children’s Hospital describes a machine learning tool for timely identification of hospitalized children at risk for deterioration – a…

Featured Researcher — Jonathan Slaughter, MD, MPH
 Featured Researcher — Jonathan Slaughter, MD, MPH 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Jonathan Slaughter, MD, MPH, neonatologist and principal investigator in the Center for Perinatal Research at Nationwide Children’s Hospital, works to identify best practices and reduce treatment variation to improve neonatal clinical care and outcomes. His career took off when, after casually observing practice variation across the institutions where he received training, he noticed that preterm…

Nephrotoxic Medications in the NICU
 Nephrotoxic Medications in the NICU 1024 575 Mary Bates, PhD
By: Mary Bates, PhD
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

New study shows treatment with nephrotoxic medications in newborns is associated with the development of acute kidney injury, yet remains common. A multicenter analysis of nearly 50 pediatric hospitals showed that newborns are commonly treated with nephrotoxic medications and, troublingly, the prevalence of acute kidney injury is higher in newborns treated with these drugs. The…

Quality Improvement Scorecard Enhances Safety for Newborns
 Quality Improvement Scorecard Enhances Safety for Newborns 1024 683 Emily Siebenmorgen
By: Emily Siebenmorgen

The collaborative program between academic and community hospitals improves neonatal care quality. In a recent study published in The Journal of Pediatrics, researchers from Nationwide Children’s Hospital and affiliated level one and two community hospital nurseries implemented a quality improvement (QI) scorecard and found improvements in important perinatal outcomes. “Roughly half of all newborns in…

Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU
 Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU 1024 681 Mary Bates, PhD
By: Mary Bates, PhD
sleeping infant

Guidelines to reduce vancomycin use at three Ohio NICUs did not impact mortality rate. In 2014, the Neonatal Antimicrobial Stewardship Program at Nationwide Children’s Hospital recommended nafcillin rather than vancomycin for empirical therapy of possible late-onset sepsis in infants without a history of methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. In a new study, researchers…