Dr. Brion's current research interest is focused on (1) improving nutrition and growth in very preterm and very low birth weight infants and (2) using evidence-based medicine to improve morbidity and morbidity in neonates. 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.
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.
Among extremely low gestational age neonates (ELGANs) a serum Zinc concentration was obtained in 52 with insufficient linear growth (17%). Zinc deficiency was diagnosed in 33% small for GA (SGA) compared to 13% non-SGA infants (P=0.01). Zinc supplementation for >2 weeks improved head growth (but not weight gain on linear growth) to discharge or 50 weeks postmenstrual age in infants with Zn deficiency. However, neither linear growth nor weight gain improved with Zn supplementation.
The next step in quality improvement aims at decreasing the frequency of growth failure, optimizing timing and amount of supplementation of micronutrients including zinc, and reducing the frequency of necrotizing enterocolitis.
Dr. Brion is also collaborating with several co-investigators (Chan CS, Kong JY, Babata K, Thai Yeo K, Mazarella K, Adhikari E, Hascoët JM) and with the Neonatal Review Group of the Cochrane Collaboration (Roger Soll and Colleen Ovelman) to analyze delivery room practices and breast milk approaches designed to optimize outcomes in neonates exposed to SARS-COV-2.
Dr. Brion has published more than 130 original manuscripts and 12 chapters. 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 Review Group of the Cochrane Collaboration. He has participated in 5 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.
Dr. Brion was Director of the Fellowship Training Program in Neonatal-Perinatal Medicine at AECOM in 1997-2006 and 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.
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.
- Medical School
- Universite Libre de Bruxelles (1976)
- Hopital Universitaire Saint-Pierre (1979), Pediatrics
- Institut Edith Cavell (1981), Pediatrics
- Hospital for Sick Children (1982), Neonatal-perinatal Medicine
- Institut Edith Cavell (1982), Neonatal-perinatal Medicine
- Cliniques Universitaires (1983), Neonatal-perinatal Medicine
- Albert Einstein College of Medicine/Montefiore Medical Center (1985), Neonatal-perinatal Medicine
- Montefiore Medical Center/ Albert Einstein College of Medicine (1986), Pediatrics
- COVID-19; SARS-COV-2
- Evidence-based medicine
- Interventions to reduce mortality and morbidity in neonates
- Neonatal nutrition and growth
- Quality improvement
- Delivery Room Continuous Positive Airway Pressure and Pneumothorax.
- Smithhart W, Wyckoff MH, Kapadia V, Jaleel M, Kakkilaya V, Brown LS, Nelson DB, Brion LP, Pediatrics 2019 Aug
- Association between Policy Changes for Oxygen Saturation Alarm Settings and Neonatal Morbidity and Mortality in Infants Born Very Preterm.
- Foglia EE, Carper B, Gantz M, DeMauro SB, Lakshminrusimha S, Walsh M, Schmidt B, J. Pediatr. 2019 06 209 17-22.e2
- 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
Neonatal jaundice. In AAP Textbook of Pediatric Care
Kapadia VS, Brion LP (2015). Elk Grove Village, IL, McInerny T, Adam HM, Campbell DE, Foy JM, Kamat, DM, and DeWitt TG. American Academy of Pediatrics.
Neonatal jaundice. In AAP Textbook of Pediatric Care
Kapadia VS, Brion LP (). Elk Grove Village, IL, McInerny T, Adam HM, Campbell DE, Foy JM, Kamat, DM, and DeWitt TG. American Academy of Pediatrics.
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. (2014). 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
Renal disease.. In MacDonald MG, Mullett MD, Seshia MMK. Avery's Neonatology: Pathophysiology and Management of the Newborn.
Nafday SM, Woda CB, Saland JM, Flynn JT, Askenazi D, Benchimol C, Brion (2020). Philadelphia., JB Lippincott Company,
Neonatal Jaundice. In Neonatology for Primary Care
Johnson KA, Maple BB, Brion LP (2020). Elk Groove 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
- 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
Childrens 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
- America's Registry of Outstanding Professionals
Americas Registry of Outstanding Professionals (2002-2003)
- Listed in Guide to Americas Pediatricians
Consumers Research Council of America (2002-2003)
Strathmores Whos 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
- 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'
- Scholarship Award in Pediatrics
Université Libre de Bruxelles, Brussels, Belgium (1976-1977)
- Prix Fleurice Mercier
Université Libre de Bruxelles (1970-1971)
- American Pediatric Society (2014)
- American Academy of Pediatrics
- American Medical Association
- Society of Pediatric Research