Narayan Iyer, MD
Dr. Narayan Iyer is an Attending Neonatologist at the Fetal and Neonatal Institute at Children’s Hospital Los Angeles and an Associate Professor of Clinical Pediatrics at the Keck School of Medicine of USC.
A fellow of the American Thoracic Society, Dr. Iyer also holds membership with the Society of Pediatric Research. Dr. Iyer has expertise in neonatal lung physiology and is an expert in the management of severe bronchopulmonary dysplasia. His research focuses on developing and validating lung function measures in infants with chronic lung disease. Dr. Iyer is also an expert in developing clinical practice guidelines and has been a Co-Chair of the Evidence Synthesis Methodology Working group of the American Thoracic Society.
Dr. Iyer earned his medical degree from the University of Kerala (India) and completed his pediatric residency and internship at the MetroHealth Medical Center, Cleveland. He completed a fellowship in neonatal and perinatal medicine at the Case Western Reserve University’s MetroHealth Medical Center/Cleveland Clinic fellowship program before joining the faculty of the USC division of Neonatal Medicine in 2014.
Chronic Lung Disease of infancy
Respiratory Failure of Newborn
Children's Interstitial Lung Disease
Apnea of Prematurity
Ventilator management
Education
T.D. Medical College, India
MetroHealth Medical Center/Cleveland - MD
MetroHealth Medical Center/Cleveland - MD
Accomplishments
General Pediatrics, American Board of Pediatrics
Neonatal- Perinatal Medicine, American Board of Pediatrics
American Thoracic Society
Western Society of Pediatric Research
GRADE Working Group
Guideline International Network
Alessandra Lisi Award for research in Turner syndrome. International Clearinghouse of Birth Defects Surveillance and Research, an affiliate organization of the World Health Organization.
Publications
Iyer NP, Rotta AT, Essouri S, Fioretto JR, Craven HJ, Whipple EC, Ramnarayan P, Abu-Sultaneh S, Khemani RG. Association Of Extubation Failure Rates With High Flow Nasal Cannula, Continuous Positive Airway Pressure, and Bilevel Positive Airway Pressure vs Conventional Oxygen Therapy and Young Children. A Systematic Review and Network Metanalysis. JAMA Pediatr. Published online June 05, 2023. doi:10.1001/jamapediatrics.2023.1478. PubMed PMID: 37273226.
Yamashiro, SM, Iyer, NP. Infant periodic breathing and apneic threshold. Physiological Reports. 2024. 12, e15915. https://doi.org/10.14814/phy2.15915. PMID: 38243332.
Hicks T, Cameron J, Wang S, Ashrafi A, Szmuszkovicz J, Iyer N, and Bansal M. Assessing the Role of Tracheostomy Placement in Bronchopulmonary Dysplasia with Pulmonary Hypertension. J Perinatol. 2024 Feb 5. doi:10.1038/s41372-024-01881-y. Epub ahead of print. PMID: 38316933.
Lewis T, Jensen E.A, Courtney S, Slaughter J, Kielt M.J, Iyer NP, Gauldin C, Nitkin C, Yeh H-W, Truog W. Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia. J Perinatol. 2024. https://doi.org/10.1038/s41372-024-02177-x.
Shanthikumar S, Gower WA, Cooke KR, Bergeron A, Schultz KR, Barochia A, Tamae-Kakaz M, Charbek E, Reardon EE, Calvo C, Cheng PC, Cole TS, Cooke KR, Davies SM, De A, Gross J, Mechinaud F, Sheshadri A, Siddaiah R, Teusink-Cross A, Towe CT, Walkup LL, Yanik GA, Bergeron A, Casey A, Deterding RR, Liptzin DR, Schultz KR, Iyer NP, Goldfarb S. Detection of Bronchiolitis Obliterans Syndrome after Pediatric Hematopoietic Stem Cell Transplantation: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2024 Aug 1;210(3):262-280. doi:10.1164/rccm.202406-1117ST. PMID: 38889365.
Research
Research Interests
Bronchopulmonary dysplasia
Neonatal pulmonary physiology
Evidence synthesis and guideline development
Research Topics
Extubation failure in newborn infants: causes and prediction
Non-invasive respiratory support of newborn infants
Non-invasive respiratory monitoring of newborn infants
Research Focus / Overview
Dr. Iyer’s research is focused on improving extubation prediction and post extubation respiratory support. In his current study he aims to measure the effort of breathing during different modes of pre-extubation spontaneous breathing trials (SBT) and describe the prevalence of respiratory muscle weakness using integrated esophageal manometry and respiratory inductance plethysmography (RIP).
Key Findings
In his most recent published study, he describes the risk of hyperoxemia with different levels of inspired oxygen. In a recently concluded study, Dr. Iyer describes the impact of weakness of respiratory muscles on pediatric extubation outcomes. In a different study, he also shows the recruitment pattern of neonatal diaphragm is different in infants who fail extubation. We have also evaluated equipment used to provide non-invasive respiratory support and the results have showed the efficacy of RAM nasal cannula and high flow nasal cannula in providing respiratory support.
Current Funding
Garland Foundation
Current Research Studies
A comparison of different modes of spontaneous breathing trials in newborn infants.
Risk profiles for hyperoxemia in newborn infants.
Research Studies
Validate the use of respiratory inductance plethysmography (RIP) and esophageal manometry in diagnosing upper airway obstruction (UAO) in newborn infants.
