Biography

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Dr. Brion's current research interest is focused on improving nutrition and growth in very preterm and very low birth weight infants. He has obtained funding from Children’s Medical Center Foundation at Dallas and from the Gerber Foundation. His research and quality improvement projects address the relationship between neonatal nutrition, growth, neurodevelopment and signs suggestive of metabolic syndrome in high-risk preterm infants. Specifically, valid serial length measurements in preterm infants were shown to permit characterization of growth patterns. Adjustable feedings plus accurate serial length measurements decreased weight-length disproportion at discharge in very preterm infants. In preterm infants fed human milk, milk fortification can be adjusted by 1) optimization, based on growth rate and serum analyses, or 2) individualization, based on daily human milk nutrient analysis. Randomized allocation to adjusting macronutrients based on breast milk analysis in preterm neonates did not improve weight gain, linear growth or weight/length disproportion at 36 weeks postmentrual age or discharge. Long-term follow-up of these infants is now in process to assess the development of signs of metabolic syndrome and neurodevelopment. The next step in quality improvement aims at decreasing the frequency of growth failure and necrotizing enterocolitis.

Dr. Brion has published more than 70 original research manuscripts. During his training in pediatrics and in neonatology, he participated and conducted studies on growth, nutrition and assessment of renal function in neonates and children. As Faculty at the Albert Einstein College of Medicine in New York (AECOM), he was funded for years by the NIH, American Heart Association, Genentech Foundation, and Pharmacia for basic sciences research in developmental nephrology, specifically renal acid secretion, carbonic anhydrase, pathophysiological effects of acidosis and growth.

Dr. Brion’s academic focus later changed to clinical research assessing neonatal mortality and morbidity and evidence-based medicine. He is a member of the Neonatal Cochrane Collaboration Group. He has authored several Cochrane reviews and has participated in 3 randomized controlled trials (RCTs) in preterm infants. Dr. Brion has served on the IRB at AECOM. He has participated in several multi-center research studies. Since 2009, he has been the University of Texas Southwestern (UTSW) Alternate PI for the NICHD Eunice Kennedy Shriver Cooperative Multicenter Neonatal Research Network (NRN). Dr. Brion serves on the subcommittee on protection of human subjects of the NRN, is co-investigator in 3 protocols in the pipeline, and has reviewed 4 manuscripts. He has co-authored manuscripts published by the NRN: one pilot randomized trial on vitamin E, and one study that showed changes in practice after a randomized trial and one randomized trial on inositol. 

Dr. Brion was Director of the Fellowship Training Program in Neonatal-Perinatal Medicine at AECOM in 1997-2006 and has been Director of the Fellowship Training Program in Neonatal-Perinatal Medicine at UTSW in 2007-2019. He has been research mentor for more than 25 trainees. He is one of 3 neonatologists who teach an evidence-based medicine course twice a month for Fellows in Neonatal-Perinatal Medicine at UTSW. This course includes an evidence-based decision making series.

In 2013 Dr. Brion took the Clinical Safety and Efficacy Course at UTSW. He supervises a team of research nurses who maintain the Divisional extensive neonatal intensive care unit (NICU) clinical databases at Parkland and Children’s Medical Center and databases for the Vermont Oxford Neonatal Network (VON) and Children’s Hospital Network Database (CHND). He compiles and presents an Annual Report of mortality and morbidity of neonates admitted to Parkland NICU and compares them to those of the NICHD NRN, VON and national data. He has used the databases for quality improvement and for research, including preliminary data for the proposed research.

 

Education

Medical School
Universite Libre de Bruxelles (1976)
Residency
Hopital Universitaire Saint-Pierre (1979), Pediatrics
Residency
Institut Edith Cavell (1981), Pediatrics
Fellowship
Hospital for Sick Children (1982), Neonatal-perinatal Medicine
Fellowship
Institut Edith Cavell (1982), Neonatal-perinatal Medicine
Fellowship
Cliniques Universitaires (1983), Neonatal-perinatal Medicine
Fellowship
Albert Einstein College of Medicine/Montefiore Medical Center (1985), Neonatal-perinatal Medicine
Residency
Montefiore Medical Center/ Albert Einstein College of Medicine (1986), Pediatrics

Research Interest

  • Evidence-based medicine
  • Interventions to reduce mortality and morbidity in neonates
  • Neonatal nutrition and growth

Publications

Featured Publications LegendFeatured Publications

Outcomes of Extremely Preterm Infants With Birth Weight Less Than 400 g.
Brumbaugh JE, Hansen NI, Bell EF, Sridhar A, Carlo WA, Hintz SR, Vohr BR, Colaizy TT, Duncan AF, Wyckoff MH, Baack ML, Rysavy MA, DeMauro SB, Stoll BJ, Das A, Higgins RD JAMA Pediatr 2019 Mar
Neurodevelopmental outcomes among extremely premature infants with linear growth restriction.
Meyers JM, Tan S, Bell EF, Duncan AF, Guillet R, Stoll BJ, D'Angio CT J Perinatol 2019 Feb 39 2 193-202
Adjustable Feedings plus Accurate Serial Length Measurements Decrease Weight-Length Disproportion in Very Preterm Infants.
Brion LP, Rosenfeld CR, Heyne R, Brown LS, Lair C, Burchfield P, Caraig M. J Perinatol 2019
Decrease in Frequency of Treatment for Patent Ductus Arteriosus after Implementation of Consensus Guidelines: A 15-Year Experience
Pavageau P, Brion LP, Rosenfeld CR, Brown LS, Ramaciotti C, Burchfield PJ, Jaleel MA. J Perinatol 2019
Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial.
Shankaran S, Bell EF, Laptook AR, Saha S, Newman NS, Kazzi SNJ, Barks J, Stoll BJ, Bara R, Gabrio J, Childs K, Das A, Higgins RD, Carlo WA, Sánchez PJ, Carlton DP, Pavageau L, Malcolm WF, D'Angio CT, Ohls RK, Poindexter BB, Sokol GM, Van Meurs KP, Colaizy TT, Khmour A, Puopolo KM, Garg M, Walsh MC J. Pediatr. 2018 Oct
Effects of Myo-inositol on Type 1 Retinopathy of Prematurity Among Preterm Infants <28 Weeks' Gestational Age: A Randomized Clinical Trial.
Phelps DL, Watterberg KL, Nolen TL, Cole CA, Cotten CM, Oh W, Poindexter BB, Zaterka-Baxter KM, Das A, Lacy CB, Scorsone AM, Walsh MC, Bell EF, Kennedy KA, Schibler K, Sokol GM, Laughon MM, Lakshminrusimha S, Truog WE, Garg M, Carlo WA, Laptook AR, Van Meurs KP, Carlton DP, Graf A, DeMauro SB, Brion LP, Shankaran S, Orge FH, Olson RJ, Mintz-Hittner H, Yang MB, Haider KM, Wallace DK, Chung M, Hug D, Tsui I, Cogen MS, Donahue JP, Gaynon M, Hutchinson AK, Bremer DL, Quinn G, He YG, Lucas WR, Winter TW, Kicklighter SD, Kumar K, Chess PR, Colaizy TT, Hibbs AM, Ambalavanan N, Harmon HM, McGowan EC, Higgins RD JAMA 2018 10 320 16 1649-1658
Valid serial length measurements in preterm infants permit characterization of growth patterns.
Pavageau L, Rosenfeld CR, Heyne R, Brown LS, Whitham J, Lair C, Brion LP J Perinatol 2018 Sep
Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort.
Vohr BR, Heyne R, Bann CM, Das A, Higgins RD, Hintz SR J. Pediatr. 2018 May
Outcome of Preterm Infants with Transient Cystic Periventricular Leukomalacia on Serial Cranial Imaging Up to Term Equivalent Age.
Sarkar S, Shankaran S, Barks J, Do BT, Laptook AR, Das A, Ambalavanan N, Van Meurs KP, Bell EF, Sanchez PJ, Hintz SR, Wyckoff MH, Stoll BJ, Carlo WA J. Pediatr. 2018 Feb
Validity of Level of Supervision Scales for Assessing Pediatric Fellows on the Common Pediatric Subspecialty Entrustable Professional Activities.
Mink RB, Schwartz A, Herman BE, Turner DA, Curran ML, Myers A, Hsu DC, Kesselheim JC, Carraccio CL Acad Med 2018 02 93 2 283-291

Books

Featured Books Legend Featured Books

Clinical significance of developmental renal physiology. In Fetal and Neonatal Physiology

Brion LP, Satlin LM (1998). Philadelphia, PA: Saunders.

Kidney and Urinary Tract. In Fanaroff AA, Martin RJ, eds. Neonatal-Perinatal Medicine.

Brion LP, Bernstein J, Spitzer A. (1997). St. Louis, MO: Mosby.

Renal disease. In MacDonald MG, Mullett MD, Seshia MMK. Avery's Neonatology: Pathophysiology and Management of the Newborn.

Nafday S, Brion LP, Benchimol C, Satlin LM, Flynn J, Edelmann CM Jr. (2004). Philadelphia, PA: JB Lippincott Company.

Renal disease. In MacDonald MG, Mullett MD, Seshia MMK, eds. Avery's Neonatology: Pathophysiology and Management of the Newborn

Nafday SM, Woda CB, Saland JM, Flynn JT, Askenzi D, Benchimol C, Brion LP. (2015). Philadelphia, PA: JB Lippincott Company.

Neonatal Jaundice. In Campbell DE, ed. Neonatology for Primary Care.

Kapadia VS, Brion LP. (2015). Elk Grove Village, IL: American Academy of Pediatrics.

Neonatal jaundice in the term and near term infant. In TK McInerny, HM Adam, DE Campbell, DM Kamat, KJ Kelleher, eds. American Academy of Pediatrics Textbook of Pediatric Care.

Brion LP. (2009). Elk Grove Village, IL: American Academy of Pediatrics.

Renal Disease. In MacDonald MG, ed. Neonatology: Pathophysiology and Management of the Newborn.

Brion LP, Satlin LM, Edelmann CM Jr. (1999). Philadelphia, PA: JB Lippincott Company.

Neonatal jaundice.. In Campbell DE. Neonatology for Primary Care

Johnson KA, Maple BB, Brion LP. (2019, in press). Elk Grove Village, IL, American Academy of Pediatrics

The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children and adolescents.. In Pediatric Clinics of North America

Schwartz GJ, Brion LP, Spitzer A. (1986). Phildelphia, PA, Elsevier

Carbonic anhydrases in the nervous system. In WR Chegwidden, ND Carter, YH Edwards. The carbonic anhydrases: New Horizons.

Cammer WB, Brion LP (2000). Basel, Switzerland, Birkhäuser Verlag

Honors & Awards

  • Elected to American Pediatric Society
    (2015)
  • ‘Individualizing and Optimizing Nutrition to Prevent Metabolic Syndrome and To Improve Neurodevelopment in Preterm and Small for Gestational Age Infants’
    Gerber Foundation, National Grant (2015-2019)
  • ‘Optimizing Individual Nutrition in Preterm Very Low Birth Weight Infants’
    Children’s Medical Center Clinical Advisory Committee (CCRAC) – Senior Investigator Research Award New Direction (2015-2017)
  • Site Alternate PI, UTSW, Dallas
    National Institute of Child Health and Human Development Eunice Kennedy Shriver Cooperative Multicenter Neonatal Research Network: (2011-2021)
  • Recognition by program directors for special contribution
    COGME, Albert Einstein College of Medicine, Bronx, NY (2006)
  • Listed in Top Doctors
    American Registry (2004-2005)
  • Best Doctors in America
    (2003-2014)
  • America's Registry of Outstanding Professionals
    (2002-2003)
  • Listed
    America’s Registry of Outstanding Professionals (2002-2003)
  • Listed in “Guide to America’s Pediatricians”
    Consumer’s Research Council of America (2002-2003)
  • Listed
    Strathmore’s Who’s Who (2001-2003)
  • New York Metro Area Top Doctors
    Castle Connolly Medical Ltd (2001-2005)
  • Listed in 3rd & 4th Eds, How to Find the Best Doctors: New York Metro Area
    Castle Connolly Guide (1998-1999)
  • Listed in ‘The Best Doctors in New York,’ Neonatal-Perinatal Medicine,
    New York Magazine (1998-2002)
  • Grant-in-Aid: ‘Regulation of renal membrane-bound carbonic anhydrase in response to acidosis’
    American Heart Association (1997-1999)
  • ‘Hormonal and cellular mechanisms of failure to thrive in acidotic mice’
    Pharmacia Inc (1997-1999)
  • Hormonal mechanisms of growth failure in chronic acidosis
    Pharmacia (1996-1997)
  • ‘Hormonal mechanisms of growth failure in chronic acidosis’
    Genentech Foundation for Growth and Development (1996-1998)
  • Interdivisional Research Award (IRA), ‘Role of somatotropin in growth retardation associated with chronic metabolic acidosis’
    Department of Pediatrics, Montefiore Medical Center (1995-1997)
  • “Molecular regulation of carbonic anhydrase IV isozymes’
    Department of Pediatrics Internal Grant, Montefiore Medical Center (1995-1997)
  • Biomedical Research Grants & Crisis Support Grant
    Albert Einstein College of Medicine (1990-1996)
  • Clinical Investigator Award: 'Regulation and development of renal acid-base transport'
    NIDDK (1990-1995)
  • Scholarship Award in Pediatrics
    Université Libre de Bruxelles, Brussels, Belgium (1976-1977)
  • Prix Fleurice Mercier
    Université Libre de Bruxelles (1970-1971)

Professional Associations/Affiliations

  • American Pediatric Society (2014)
  • American Academy of Pediatrics
  • American Medical Association
  • Society of Pediatric Research