Narayan Iyer, MD

Attending Neonatologist

Associate Professor of Clinical Pediatrics, Keck School of Medicine of USC

Dr. Iyer is a Neonatologist with additional training in systematic reviews and guideline development.

Clinical Interests

Respiratory Failure of Newborn
Chronic Lung Disease of infancy
Children's Interstitial Lung Disease
Apnea of Prematurity

Education

Medical School

T.D. Medical College, India

Residency

MetroHealth Medical Center/Cleveland - MD

Fellowship

MetroHealth Medical Center/Cleveland- MD

Accomplishments

Certifications

General Pediatrics - American Board of Pediatrics
Neonatal- Perinatal Medicine- American Board of Pediatrics

Professional Memberships

American Thoracic Society
Society of Pediatric Research
GRADE Working Group

Awards

Alessandra Lisi Award for research in Turner syndrome. International Clearinghouse of Birth Defects Surveillance and Research, an affiliate organization of the World health Organization.

USC Bio Link

USC Bio

Publications

Feller-Kopman DJ, Reddy CB, DeCamp MM, Diekemper RL, Gould MK, Henry T, Iyer NP, Lee YCG, Lewis SZ, Maskell NA, Rahman NM, Sterman DH, Wahidi MM, Balekian AA. Management of Malignant Pleural Effusions: An Official American Thoracic Society / Society of Thoracic Surgeons / Society of Thoracic Radiology Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198 (7). PMID: 30272503. https://doi.org/10.1164/rccm.201807-1415ST

Iyer NP, Reddy CB, Wahidi MM, Lewis SZ, Diekemper RL, Feller-Kopman D, Gould M, Balekian AA. Indwelling Pleural Catheter versus Pleurodesis for Malignant Pleural Effusions: A Systematic Review and Meta-Analysis. Annals of American Thoracic Society 2018. Articles in Press. PMID: 30272486. https://doi.org/10.1513/AnnalsATS.201807-495OC

TE Bachman, CJL Newth, PA Ross, NP Iyer, RG Khemani. Hypoxemic and hyperoxemic likelihood in pulse-oximetry ranges: NICU observational study. Archives of Disease in Childhood. Archives of Disease in Childhood - Fetal and Neonatal Edition Published Online First: 20 June 2018. doi: 10.1136/archdischild-2017-314448.

Chavez TA, Lakshmanan A, Figueroa L, Iyer N, Stavroudis T, Garingo A, Friedlich P, Ramanathan R. Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome. J Perinatol. 2018 May 24. doi: 10.1038/s41372-018-0122-y. [Epub ahead of print]

Iyer NP, Dickson J, Ruiz ME, Chatburn R, Beck J, Sinderby C, Rodriguez RJ. Neural breathing pattern in newborn infants pre- and postextubation. Acta Paediatr. 2017 Dec;106(12):1928-1933. doi: 10.1111/apa.14040. Epub 2017 Sep 12.

PubMed Link

Publications on PubMed

Research

Pulmonary mechanics
Extubation failure
Respiratory muscle weakness
Assessment of technology used to provide respiratory support in newborn infants
Implementation of guidelines

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

Extubation failure in newborn infants

Validate the use of respiratory inductance plethysmography (RIP) and esophageal manometry in diagnosing upper airway obstruction (UAO) in newborn infants.