As the chief of the division of neonatology in the Department of Pediatrics, I oversee clinical, teaching, research and administrative tasks related to the evaluation and treatment of critically ill preterm and term newborn infants, and I am actively involved in teaching medical students, pediatric residents and fellows in neonatal-perinatal medicine. My practice is primarily located at the Neonatal Intensive Care Unit (NICU) at the Women and Children’s Hospital of Buffalo. My division provides high-risk newborn care at Millard Fillmore Suburban Hospital, plus telephone consultation and transport services for sick newborn infants throughout Western New York.
Over the past decade, I have developed an interest in managing newborn infants with hypoxic respiratory failure and persistent pulmonary hypertension of the newborn (PPHN). I have investigated the role oxygen free radicals, nitric oxide and antioxidants play in the pathogenesis and management of PPHN. More recently, I have focused my attention on optimal strategies for neonatal resuscitation. Based on this work, I have published and co-authored more than 40 peer-reviewed manuscripts.
As the director of the Center for Developmental Biology of the Lung, my research focuses on the pathophysiology of the cardio-pulmonary transition – how fetal lungs change at birth in order to breathe air – and disorders of this transition such as birth asphyxia, PPHN, retained lung liquid and respiratory distress syndrome. My laboratory’s translational research aims primarily at preventing and treating these disorders with optimal neonatal resuscitation techniques, steroids, nitric oxide, surfactant and judicious use of oxygen.
In 2011, our division joined the NICHD Neonatal Research Network – a group of 18 Academic Neonatal Centers to conduct multicenter trials with the goal of improving outcomes in sick preterm and term neonates. Together, we work to transfer innovative discoveries from our laboratory to the bedside through clinical trials, improving outcomes for this vulnerable population.
Education and Training:
MD, Pediatric Medicine, Mysore Medical College, Top rank in the university (highest score) (1995)
MBBS, Medicine/Surgery, Mysore Medical College (1990)
Employment:
Chief, Division of Neonatology, Pediatrics, Women and Children‘s Hospital of Buffalo (2011-present)
Director, Center for Developmental Biology of the Lung (CDBL), Women and Children's Hospital of Buffalo (2011-present)
Associate Professor, Pediatrics, University at Buffalo (2009-present)
Associate Director, Neonatal-Perinatal Medicine Fellowship Program, University at Buffalo (2003-present)
Assistant Professor, Pediatrics, University at Buffalo (2003–2008)
Pediatrician/Neonatologist, Pediatric Associates of Southern Colorado (2000–2003)
Clinical Assistant Professor, Pediatrics, University at Buffalo (1999–2003)
Clinical Instructor, Pediatrics, University at Buffalo (1996–1999)
Awards and Honors:
Eastern Society for Pediatric Research: Faculty Young Investigator Award (2008)
Best Doctors in America (2007)
Research Expertise:
Fetal surgery: Ligation of fetal ductus arteriosus
Isolated vessel bath studies: Use of tissue baths to study isolated vessels and airways
Grants and Sponsored Research:
August 2012–August 2017 OPTIMAL OXYGENATION IN NEONATAL LUNG INJURY NICHD Role: Principal Investigator $1,163,817
April 2011–March 2016 Capitation from Neonatal Research Network studies NICHD Role: Principal Investigator $129,750
July 2010–June 2015 REDOX REGULATION IN THE PERINATAL PULMONARY VASCULATURE NIH (NHLBI) Role: Co-Investigator $568,750
April 2011–March 2014 Neonatal Research Network - NICHD NICHD Role: Co-Principal Investigator $608,655
March 2012–February 2014 AAP - NRP 2012 GrantTracheal suctioning in spontaneous meconium aspiration American Academy of Pediatrics Role: Principal Investigator $40,000
January 2012–December 2013 AAP Young Investigator Grant - MentorThe Use of Pulse Oximetry in the Assessment of Effective Chest Compressions During Neonatal Resuscitation. American Academy of Pediatrics Role: Consultant $10,000
September 2010–June 2013 Phase II trial of sildenafil in newborns with persistent pulmonary hypertension NHLBI Role: Co-Investigator $150,853
November 2010–October 2012 Ikaria Investigator sponsored grant : Early initiation of inhaled nitric oxide improves oxygenation in PPHN Ikaria LLC Role: Principal Investigator $160,000
January 2010–December 2011 AAP/NRP Young Investigator Grant American Academy of Pediatrics Role: Consultant $10,000
May 2009–April 2011 Antenatal betamethasone in late-preterm gestation lambs NICHD Role: Principal Investigator $146,000
January 2006–April 2010 cGMP Regulation in the developing Pulmonary Circulation NHLBI Role: Co-Investigator $528,000
January 2007–December 2007 American Academy of Pediatrics / Neonatal Resuscitation Program Award American Academy of Pediatrics Role: Principal Investigator $25,000
Black SM, Bekker JM, McMullan DM, Parry AJ, Ovadia B, Reinhartz O, Lakshminrushimha S, Mata-Greenwood E, Steinhorn RH, Fineman JR, Lakshminrusimha S. Alterations in nitric oxide production in 8-week-old lambs with increased pulmonary blood flow.. Pediatr Res. 2002; 52(2).
Lakshminrusimha S, D'Angelis CA, Russell JA, Nielsen LC, Gugino SF, Nickerson PA, Steinhorn RH. C-type natriuretic peptide system in fetal ovine pulmonary vasculature.. Am J Physiol Lung Cell Mol Physiol. 2001; 281(2).
Steinhorn RH, Russell JA, Lakshminrusimha S, Gugino SF, Black SM, Fineman JR. Altered endothelium-dependent relaxations in lambs with high pulmonary blood flow and pulmonary hypertension.. Am J Physiol Heart Circ Physiol. 2001; 280(1).
Bommaraju M, Kumar VH, Lakshminrusimha S, Ryan RM, Morin FC III. Vascular therapies in acute lung injury. Lung injury: mechanism – pathophysiology – therapy. 2003.
Professional Memberships:
Soceity for Pediatric Research (2006)
American Academy of Pediatrics (1996)
Presentations:
"Dilating the Pulmonary Vascular Bed" Neo Conference for Neonatologists, Pediatrix, Respiratory Section (2012)
"Dilating the Pulmonary Vascular Bed" ECMO Conference, Children‘s National Medical Center, Neonatal lung - science behind our therapies (2012)
"Pulmonary Vasodilation" ECMO Conference, Children‘s National Medical Center (2012)
"Recent Advances in Neonatology" Pediatric Grand Rounds, Women & Children‘s Hospital of Buffalo (2012)
"Neonatal Pulmonary Hemodynamics" Neonatal Research Presentation - Westchester Medical Center (2011)
"Neonatal Resuscitation" Grand Rounds - Penn State Hershey Medical Center (2011)
"Persistent Pulmonary Hypertension of the Newborn" Grand Rounds - Westchester Medical Center (2011)
"How to Prepare for Pediatric Board Examinations" Pediatric Resident Noon Talks - Winthrop, Winthrop Hospital (2011)
"Is Oxygen a Pulmonary Vasodilator?" American Academy of Pediatrics - Chapter 2 (2011)
"Neonatal Hypoxic Respiratory Failure" Grand Rounds - Tufts University, Tufts University Medical Center, Pediatrics (2011)
"Challenges in Neonatal Resuscitation and Oxygen Use" Neonatology Research - Rush University Medical Center, Chicago IL (2011)
"Hemodynamics in Neonatal Hypoxemic Respiratory Failure" Grand Rounds - Rush Medical Center Chicago IL, Rush Medical Center, Pediatrics (2011)
"Oxygenation and Hemodynamics in Neonatal Lung Injury" Pulmonary Biology Seminar, Women & Children's Hospital of Buffalo (2011)
"What is New in Neonatal Resuscitation" Emergency Medicine Grand Rounds, Buffalo General Hospital (2011)
"Neonatal Resuscitation Guidelines 2011" Grand Rounds, Women & Children's Hospital of Buffalo (2011)
"Persistent Pulmonary Hypertension of the Newborn" Core Curriculum Lecture Series, Women & Children's Hospital of Buffalo (2011)
"Advances in management of PPHN" Perinatal Symposium at Westchester Medical Center (2011)
"Antenatal Betamethasone Improves Pulmonary Transition in Late Preterm Lambs Delivered by Elective Cesarean Section" SPR/PAS (2011)
"Changes in NRP 2011 - A Brief Overview" SPR/PAS (2011)
"Effect of FiO2 and NO on Oxygenation and Pulmonary Vascular Resistance at Birth" SPR/PAS (2011)
"Effect of Inspired Oxygen and Inhaled Nitric Oxide (iNO) on Oxygen Uptake from the Lung and Arterial Oxygen Content in Newborn Lambs and Lambs with Persistent Pulmonary Hypertension of the Newborn (PPHN)" SPR/PAS (2011)
"Gas Exchange in the First Minute of CPR Following Asphyxial Cardiac Arrest in Newborn Piglets" SPR/PAS (2011)
"Hydrocortisone Decreases Hyperoxia-Induced PDE5 Activity in Pulmonary Artery Smooth Muscle Cells from Persistent Pulmonary Hypertension (PPHN) Lambs" SPR/PAS (2011)
"Increased Methemoglobin (MHb) Levels Predict Response to Inhaled Nitric Oxide (iNO) in Persistent Pulmonary Hypertension of the Newborn (PPHN)" SPR/PAS (2011)
"Increased Peroxynitrite is Associated with Increased Nox2 and iNOS Expression in Persistent Pulmonary Hypertension of the Newborn (PPHN)" SPR/PAS (2011)
"Intrauterine Growth Restriction Alters Lung Morphology and Function During Postnatal Growth in Rats" SPR/PAS (2011)
"Intravenous Sildenafil Improves Oxygenation and Suppresses PDE5 Activity in Lambs with PPHN" SPR/PAS (2011)
"Morbidity and NICU Admissions among Early Term (37-38 wk) and Term (39-41 wk) Neonates in Erie County (NY)" SPR/PAS (2011)
"Early Fortification of Expressed Breast Milk (EBM) Improves Calcium (Ca) and Phosphorus (P) Intake and Reduces Peak Alkaline Phosphatase (AlkP) Level in Premature Neonates" SPR/PAS (2011)
"Enteral Feeding and Antenatal Betamethasone Alter Mesenteric Vascular Reactivity in Late Preterm Lambs" SPR/PAS (2011)
"Hemodynamic Attributes in HRF" SPR/PAS (2011)
"Increased H202 Generation is Associated with Increased Nox4/p22phox Expression in Persistent Pulmonary Hypertension of the Newborn (PPHN)" SPR/PAS (2011)
"Hyperoxia, Nitric Oxide in the Neonatal Pulmonary Circulation" Neonatal Research Grand Rounds, Nationwide Children's Hospital (2011)
"Neonatal Resuscitation Guidelines 2011" Grand Rounds, Women & Children's Hospital of Buffalo (2011)
"Use of Inhaled Nitric Oxide at Birth" Pulmonary Biology Seminar, Women & Children's Hospital of Buffalo (2011)
"Hypoxic Respiratory Failure in Early Term and Term Neonates - Use of Echocardiography" Joint Obstetrics and Neonatology Conference, Jacobi Medical Center (2010)
"Pulmonary Hemodynamics - Effect of Oxygen and Nitric Oxide" Research Rounds, Columbia-Presbyterian Hospital for Children (2010)
"Oxygen, Nitric Oxide and the Neonatal Pulmonary Ciculation" Research Rounds, Hospital for Sick Children (2010)
"Physiology of Pulmonary Transition at Birth" Karolinska Developmental Exchange Program, University of Toronto (2010)
"Hypoxic Respiratory Failure in the Neonate" Annual Conference of Respiratory Therapists, St. Barnabas Medical Center (2010)
"Oxygen and Pulmonary Vasodilation" 15th Annual ECLS Symposium (2010)
"Phosphodiesterase 5 Inhibitors in PPHN" Pulmonary Biology Seminar, Women & Children's Hospital (2010)
"Congenital Heart Disease in Newborn" Mini-Medical School, University at Buffalo (2009)
"Room Air or Oxygen in the Delivery Room" Perinatal Outreach Program, University at Buffalo (2009)
"Recombinant Human Superoxide Dismutase in the Management of PPHN" Pediatric Origins of Lung Disease International Symposium, Children's Hospital of Manitoba (2009)
"Advances in Vasodilator Therapy in PPHN" Mead Johnson Symposium (2009)
"Oxigen - A Pulmonary Vasodilator" ECMO Symposium, Children's National Medical Center (2009)
"Methemoglobin as a Predictor of Response to NO in PPHN" Neonatal Thruway Conference (2008)
"Approach to Newborn with Cyanosis" Grand Rounds, Women & Children's Hospital of Buffalo (2007)
"Is Room Air Safe for Resuscitation of Neonatal Lambs with PPHN?" New York Neonatal Thruway Conference (2007)
"Pulmonary Vascular Reactivity in PPHN" Pulmonary Biology Seminar, Women & Children's Hospital of Buffalo (2007)
"Bronchial Derived Relaxing Factor - Role in Transition at Birth" New York Neonatal Thruway Conference (2006)
"Hazards of Prematurity" Grand Rounds, Mysore Medical School (2006)
"Neonatal Ventilator Management" , JSS Medical School (2006)
"Use of Supplemental Oxygen in the Delivery Room" Perinatal Outreach Program, University at Buffalo (2006)
"Oxygen and the Pulmonary Artery" Neonatology Faculty Seminar, Medical College of Wisconsin (2006)
"Oxygen, Nitric Oxide and the Pulmonary Artery" Pulmonary Biology Seminar Series, Women & Children's Hospital of Buffalo (2005)
"Resuscitation with 100% Oxygen Reduces Relaxation to Acetylcholine and Nitric Oxide" Neonatology Thruway Conference, Women and Children‘s Hospital of Buffalo (2005)
"Persistent Fetal Circulation (PFC)/PPHN" Pediatric Surgery Conference, Women & Children's Hospital of Buffalo (2005)
"Systemic hypertension in premature newborn: role of steroids and race" Pediatric Academic Society, Society for Pediatric Research, Neonatal Pharmacology (2003)
"Superoxide produced by Nitric Oxide Synthase (NOS) impairs vascular relaxations in pulmonary arteries isolated from lambs with congenital heart disease and high pulmonary blood flow" Pediatric Academic Society, Society for Pediatric Research, Cardiology (2002)
"Superoxide dismutase significantly enhances vasodilation mediated by nitric oxide donors in pulmonary arteries isolated from lambs with congential heart disease with high pulmonary blood flow" AHA 73rd Scientific Sessions, American Heart Association, Cardiovascular disease of the young (2001)
"Developmental differences in atrial natriuretic peptide (ANP) mediated relaxation of pulmonary arteries (PA) isolated from juvenile lambs with congenital heart disease (CHD) and high pulmonary blood flow" Pediatric Academic Society, Society for Pediatric Research (2001)
"Enhancement of Nitric Oxide (NO) Donor Mediated Relaxation of Pulmonary Arteries (PA)Isolated from Juvenile Lambs with Congenital Heart Disease (CHD) and High Pulmonary Blood Flow Using a Soluble Guanylyl Cyclase Sensitizer" Pediatric Academic Society, Society for Pediatric Research, Neonatal Pulmonology (2001)
"Increased Production of Reactive Oxygen Species in a Lamb Model of Persistent Pulmonary Hypertension" Pediatric Academic Society, Society for Pediatric Research (2001)
"Pulmonary veins isolated from near-term gestation ovine fetus respond uniquely in soluble guanylyl cyclase (sGC) inhibitor" Pediatric Academic Society, Society for Pediatric Research (2001)
"Altered relaxations to superoxide dismutase in pulmonary arteries from lambs with congenital heart disease with pulmonary hypertension" Pediatric Academic Society, American Academy of Pediatrics and Society for Pediatric Research, Neonatal Pulmonology (2000)
"Decreased relaxations to ET-B receptor stimulation in pulmonary vessels isolated from an ovine model of congential heart disease with high pulmonary blood flow" Pediatric Academic Societies, Society for Pediatric Research and American Academy of Pediatrics, Cardiology (2000)
"Mechanism of endogenous cyclic GMP production differ in fetal ovine pulmonary arteries versus veins" Pediatric Academic Society, American Academy of Pediatrics and Society for Pediatric Research, Neonatal Pulmonology (2000)
"Superoxide dismutase and catalase reverse impaired endothelium-dependent pulmonary arterial relaxations in an ovine model of CHD with high pulmonary blood flow" Pediatric Academic Society, American Academy of Pediatrics and Society for Pediatric Research, Cardiology (2000)
"Alterations in the Pulmonary Vascular Natriuretic peptide System in an ovine model of Persistent Pulmonary Hypertension of the newborn" AHA - 72nd Scientific Sessions, American Heart Association, Regulation of vascular responses in the pulmonar (1999)
"Superoxide dismutase relaxes pulmonary arteries from fetal sheep by a mechanism independent of NO-guanylate cyclase signaling" AHA 72nd Scientific Sessions, American Heart Association, Redox signaling in pulmonary circulation (1999)
"Alterations in the natriuretic peptide system in an ovine model of congenital heart disease" Pediatric Academic Societies, Society for Pediatric Research, Cardiology (1999)
"Mechanisms of action of natriuretic peptides in the developing ovine lung" Pediatric Academic Societies, Society for Pediatric Research (1999)
"Superoxide contributes to resting tone in pulmonary arteries by a mechanism independent of nitric oxide" Pediatric Academic Societies, Society for Pediatric Research, Pulmonary - general lung biology (1999)
"The effect of UK 114542-27, a novel cGMP phosphodiesterase inhibitor, in newborn lambs with persistent pulmonary hypertension of newborn" Pediatric Academic Societies, Society for Pediatric Research, Neonatal Pulmonology (1999)
"Localization and distribution of C-type natriuretic peptide and its receptor in fetal and six week old ovine lung" ATS Annual Conference, American Thoracic Society (1999)
"The natriuretic peptide system is altered in a model of congenital heart disease" AHA-71st Scientific Sessions, American Heart Association, Cardiovascular disease of the young (1998)
"Early endothelial dysfunction in an ovine model of congenital heart disease with high pulmonary blood flow" American Physiological Society, Endothelial regulation of vascular tone (1998)
"Developmental Differences in relaxation to natriuretic peptides in isolated ovine pulmonary vessels" Pediatric Academic Society, Society for Pediatric Research, Pharmacology (1998)
Women and Children‘s Hospital of Buffalo Division of Neonatology 219 Bryant Street Buffalo, NY 14222 Phone: (716) 878-7673 Fax: (716) 878-7945 Email: slakshmi@buffalo.edu
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