Dr. Bearl's research interests center around clinical outcomes for children with end-stage heart failure specifically patient selection, management and post-transplant outcomes for children who require a ventricular assist device (VAD). Dr. Bearl is actively involved in the international quality improvement initiative related to VAD outcomes called Advanced Cardiac Therapies Improving Outcomes Network (ACTION) and the prospective VAD research registry called Pedimacs, which is the pediatric-specific arm of Intermacs (Interagency Registry for Mechanically Assisted Circulatory Support) managed by the Society of Thoracic Surgeons (STS).

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Dr. Banerjee conducts clinical research related to surveillance of antibiotic-resistant bacteria and strategies to optimize appropriate antibiotic use. She is principal investigator on NIH and CDC-funded studies implementing and evaluating rapid diagnostics and other antibiotic stewardship interventions.

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Dr. Baldwin’s research has concentrated on delineating the molecular basis of vascular development in the mammalian embryo as an approach to understanding the etiology of congenital heart disease. The ultimate goal of his laboratory is to exploit in utero developmental mechanisms to inform the therapies for postnatal congenital heart and vascular diseases. He is particularly focused on the role of the endocardium in ventricular trabecular and compaction as well as the role of the lymphatic system in mediating additional morbidities and mortalities of patients with CHD.

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Dr. Austin is a physician-scientist specializing in translational research studies. The Austin Research Lab is a combined laboratory-based and patient-oriented translational research program that focuses on pulmonary hypertension and other cardiopulmonary morbidities in children and adults with and without preexisting known genetic risks. Our research team achieves success via close collaboration with multiple other investigative groups, particularly our colleagues in the Vanderbilt University Pulmonary Vascular Research Program (VUPVRP).

Our lab conducts a variety of short and long-term research studies with a variety of human subjects, including patients with pulmonary hypertension (PH), family members at genetic risk of developing PH, individuals with other forms of risk, and healthy subjects. In particular, our expertise focuses on evaluating the manner in which genetic, biochemical, environmental and other variations promote phenotypic expression of PH and other cardiopulmonary diseases in children and adults. We often pursue deep phenotyping in concert with biologic sample acquisition for genetic and biochemical studies at regular intervals.

To accomplish these pursuits, we employ both direct human studies and preclinical mechanistic investigations to improve our understanding of the pathogenesis of PH, especially pulmonary arterial hypertension. Applications of our work include clinical trials of novel agents for PH, sequencing and proteomic studies to identify novel variations associated with PH, pharmacoepidemiologic investigations, and biologic marker studies of perturbed sex hormone metabolism in humans with PH.

The collaborative interactions within the Vanderbilt University Pulmonary Vascular Research Program (VUPVRP) provide a rich milieu for investigation of children and adults with PH and other pulmonary vascular diseases. In total, the VUPVRP supports a wide range of studies from cells to animal models to humans. These include studies ranging from genetic and genomic investigations in humans, to in vitro-in vivo-ex vivo studies in cells and animals, to epidemiologic studies in humans, to investigator-initiated clinical trials in humans.

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Dr. Attarian focuses her academic work on neonatal nutrition and breastfeeding medicine. As an International Board Certified Lactation Consultant®, she is working to improve breast milk utilization rates, specifically mother's own milk, in the neonatal intensive care unit.

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Dr. Arnold's early contributions to science included studies to examine whether mathematic information in the pulse oximeter plethysmograph waveform can be used to measure pulsus paradoxus non-invasively and in real-time. If so, plethysmograph-estimate of pulsus paradoxus (PEP) will be a significant contribution to science and technology because it will provide clinicians an objective metric of acute exacerbation severity and response to treatment. He first studied healthy young adult participants who performed tidal-breathing through an airway circuit with adjustable inspiratory and expiratory resistance valves to generate pulsus paradoxus. PEP was calculated using a dedicated microprocessor and software program, based on change of plethysmograph waveform indices during the respiratory cycle. PEP predicted the degree of applied airway resistance. He has subsequently reported the validation of PEP using the criterion standards %-predicted FEV1 and airway resistance in the pulmonary function lab and in the emergency department with COPD and asthma. Assessment of acute asthma exacerbation severity directs treatment and the decision whether to hospitalize a patient, yet there are few objective measures to assess severity and predict outcome. His scientific contributions in this area have included work to improve assessment of acute exacerbations and to decrease variability of assessment between clinicians. These studies have examined the use of patient characteristics and clinical variables that are readily available at the bedside. He has demonstrated that select characteristics and variables can be used to accurately measure exacerbation severity and response to treatment with high inter-rater reliability. There are limited tools available to clinicians to inform hospitalization decisions for pediatric patients with acute asthma exacerbations. The scientific contributions of his team have included development and validation of the Asthma Prediction Rule (APR). This included development of both a comprehensive 15-variable and a reduced-form 5-variable prediction model for electronic decision-support. The APR might provide clinical decision-support to decrease unnecessary treatment variability, improve resource utilization, and improve patient outcomes measured using need-for-hospitalization criteria.

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