About

Venugopal Amula, MD, MS, is an Associate Professor of Pediatrics at the University of Utah and serves as the Medical Director of the Cardiac Intensive Care Unit at Primary Children’s Hospital. He received his medical degree from Osmania Medical College in India and a postgraduate degree in Pediatrics from Gandhi Medical College, India. After relocating to the United States, he completed his Pediatric residency at William Beaumont Hospital affiliated with Wayne State University in 2007. He further specialized through a dual fellowship in Pediatric Critical Care Medicine at the University of Utah in 2012 and Pediatric Cardiology at Duke University Medical Center in 2014. Dr. Amula is board certified in Pediatrics, Pediatric Cardiology, and Pediatric Critical Care. His clinical interests include postoperative care of children with critical congenital heart disease and inpatient management of children with cardiomyopathy, including mechanical circulatory support and ventricular assist devices. His research focuses on outcomes of patients with congenital heart disease and quality improvement initiatives with an emphasis on resource utilization in the cardiac intensive care unit. Dr. Amula has contributed to numerous publications in the field of pediatric cardiology and critical care, advancing understanding and management of complex congenital heart conditions.

Research topics

• Surgery
• Internal medicine
• Medicine
• Cardiology

Selected publications

• 26-A-21131-ACC SYSTEMIC TISSUE PLASMINOGEN ACTIVATOR USE FOR THROMBOLYSIS AFTER PEDIATRIC CARDIAC SURGERY

  Journal of the American College of Cardiology · 2026-03-27

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  PublisherDOI

• Volume–Outcome Relationship of Norwood Procedures: Insights from the National Pediatric Cardiology–Quality Improvement Collaborative Database

  The Annals of Thoracic Surgery · 2025-01-24 · 2 citations

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  PublisherDOI

• Abstract 4358117: Hyperoxia During Cardiopulmonary Bypass in Neonatal Congenital Heart Surgery is Associated with Worse Clinical Outcomes: A Multi-Institutional Study

  Circulation · 2025-11-03 · 1 citations

  article

  Background: Neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB) may be exposed to supraphysiologic oxygen (O 2 ) concentrations, termed hyperoxia, which has been associated with worse outcomes in single center studies. We aimed to describe variation in oxygen exposure during CPB within and across centers and determine if hyperoxia was associated with worse outcomes in a multicenter cohort of neonates undergoing cardiac surgery. Methods: We performed a retrospective study across 29 centers enrolled in CoRe-PCICS: Collaborative Research from the Pediatric Cardiac Intensive Care Society. Neonates (< 30d) who underwent Society of Thoracic Surgery STAT category 2–5 surgery with CPB between 01/2021 and 12/2022 were included. Clinical outcomes of interest were operative mortality and the composite outcome of major adverse cardiovascular events (MACE), including: cardiac arrest, extracorporeal support, stroke, and operative mortality. Logistic regression was performed to determine association between median PaO 2 during CPB and outcomes. Post-hoc subset analyses were performed on neonates with single ventricle (SV) anatomy. Results: We reviewed 1,175 neonates (median 48 per center), including 357 with SV anatomy. Variation in O 2 exposure during CPB is shown in Figure 1. There were 54 mortalities (5%) (Figure 2) and 203 MACE (17%) in total and 35 mortalities (10%) and 111 MACE (31%) in patients with SV anatomy. We observed no mortalities in neonates with median PaO 2 < 200mmHg (n=161). Analysis identified a median PaO 2 cut point of 221 mmHg as having modest predictive value for mortality (96% sensitivity, 19% specificity, Youden’s index score 0.16). In multivariate regression, hyperoxia (median PaO 2 > 221mmHg) was associated with mortality and MACE, controlling for birth weight, ventricular anatomy, non-cardiac anomalies, and CPB duration, however, not associated when also controlling for center. In a similar model among neonates with SV anatomy, hyperoxia was associated with mortality ( p =0.022) and MACE (p=0.008) (Table 1). Conclusions: In a multicenter study of neonates who underwent cardiac surgery, variation of O 2 exposure during CPB was apparent within and across centers and supraphysiologic PaO 2 values were common. Hyperoxia was associated with worse morbidity and mortality, particularly in neonates with SV anatomy. These findings underscore the need for a trial to determine if conservative oxygen titration during CPB leads to improved outcomes.

  PublisherDOI

• Extracorporeal Membrane Oxygenation in Children with Pulmonary Atresia and Intact Ventricular Septum: Mortality and Associated Outcomes

  Pediatric Cardiology · 2025-01-10

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  PublisherDOI

• Hyperoxia During Neonatal Cardiopulmonary Bypass Is Associated With Worse Clinical Outcomes: A Multi‐Institutional Study

  Journal of the American Heart Association · 2025-11-08 · 1 citations

  articleOpen access

  Background Exposure to supraphysiologic oxygen concentrations, or hyperoxia, during neonatal cardiopulmonary bypass (CPB) has been associated with worse outcomes in single‐center studies. We aimed to describe variation in oxygen exposure during CPB and determine if hyperoxia is associated with worse outcomes in a multicenter cohort of neonates undergoing cardiac surgery. Methods We conducted a retrospective study of neonates who underwent surgery with CPB between January 2021 and December 2022 at 29 centers. Primary outcomes were operative mortality and major adverse cardiovascular events, which included cardiopulmonary resuscitation, extracorporeal support, stroke, and mortality. Logistic regression assessed the associations between median partial pressure of oxygen in arterial blood (PaO 2 ) during CPB and outcomes in the entire cohort and subset of patients with single‐ventricle (SV) anatomy. Results We analyzed 1175 neonates, including 357 with SV anatomy. Median PaO 2 during CPB was 296 mm Hg (range: 54–800), with significant variation across centers ( P <0.001). There were 54 deaths (5%) and 203 major adverse cardiovascular events (17%). No patients with PaO 2 <200 mm Hg (n=161) died, and PaO 2 >221 mm Hg demonstrated modest mortality prediction (96% sensitivity, 19% specificity). In multivariable analysis, before adjustment for center, PaO 2 >221 mm Hg was significantly associated with mortality and major adverse cardiovascular events in all patients and patients with SV anatomy. After adjustment for center, associations between hyperoxia and mortality ( P =0.053) or major adverse cardiovascular events ( P =0.08) were not significant in the entire cohort but remained significant in patients with SV anatomy. Conclusions We observed significant variation in oxygen exposure during neonatal CPB across centers and significant associations between hyperoxia and worse outcomes, particularly in neonates with SV anatomy.

  PublisherDOI

• Syndecan-1 As a Clinical Marker of Fluid Overload and Acute Kidney Injury

  Pediatric Critical Care Medicine · 2025-03-31 · 2 citations

  article1st authorCorresponding
  PublisherDOI

• Electrocardiographic Changes at Presentation and Over Time in Children with Anomalous Left Coronary Artery from the Pulmonary Artery: A Multicenter Analysis

  Pediatric Cardiology · 2025-05-31

  article1st authorCorresponding
  PublisherDOI

• Reexploring the STRESS Trial: Subgroup Postoperative Outcomes Following Methylprednisolone for Infant Heart Surgery

  Pediatric Cardiology · 2025-05-02 · 1 citations

  articleOpen access

  Objective Assess the association between intraoperative methylprednisolone and specific postoperative outcomes among subgroups undergoing infant heart surgery. DESIGN: Subpopulation analyses of The Steroids to Reduce Systemic Inflammation after Infant Heart Surgery trial, a double-blind randomized placebo-controlled trial. SETTING: 24 congenital heart centers. PATIENTS: Infants (< 1 year old) undergoing heart surgery with cardiopulmonary bypass. Patients stratified by Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) Mortality Category, age, gestational age, and presence of chromosomal or syndromic diagnosis (CSD). INTERVENTIONS: Methylprednisolone (30 mg/kg) versus placebo administered into cardiopulmonary bypass pump-priming fluid. MEASUREMENTS AND MAIN RESULTS: Outcomes included death, heart transplantation, mechanical circulatory support, reinterventions, and hospital length of stay. Ranked composite outcome (death, transplant, or one of 13 major complications) was compared between placebo and methylprednisolone for each subgroup using the win ratio. Methylprednisolone did not reduce odds of death, transplant, or mechanical circulatory support for any subgroup. Those receiving methylprednisolone had fewer catheterization or surgical reinterventions after STAT Category 1-3 operations [OR 0.50 (0.29-0.86)]; and fewer reoperations for bleeding among patients undergoing STAT Category 1-3 operations [OR 0.28 (0.09-0.87)], term infants [OR 0.30 (0.12-0.76)], and those without CSD [OR 0.22 (0.07-0.68)]. Length of stay was no different between methylprednisolone versus placebo. Those without chromosomal or syndromic diagnosis demonstrated a favorable association for methylprednisolone [win ratio 1.28 (1.01-1.61)] for the composite outcome. CONCLUSION: Exploratory subpopulation analyses, although underpowered, suggest that methylprednisolone is not associated with significant harm and may benefit certain subpopulations.

  PublisherOA PDFDOI

• ECG Abnormalities, Diastolic Blood Pressure, and Adverse Events After Systemic to Pulmonary Artery Shunt in Infants with Congenital Heart Disease

  Pediatric Cardiology · 2024-09-24

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• Comparison of Ductal Stent Versus Surgical Shunt as Initial Intervention for Neonates with Pulmonary Atresia with Intact Ventricular Septum

  Pediatric Cardiology · 2024-06-06 · 3 citations

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Frequent coauthors

• Christopher W. Mastropietro

  Riley Hospital for Children

  51 shared

• Sukumar Suguna Narasimhulu

  University of Florida

  38 shared

• Katherine Cashen

  Duke Medical Center

  31 shared

• Peter Sassalos

  Christ University

  25 shared

• Arthur J. Smerling

  Columbia University Irving Medical Center

  25 shared

• John M. Costello

  Medical University of South Carolina

  23 shared

• Jason R. Buckley

  Medical University of South Carolina

  20 shared

• Adnan Bakar

  Farooq Hospital

  18 shared

Labs

• University of Utah Pediatric Cardiology and Critical Care Research LabPI

Education

• M.D.

  Osmania Medical College

• Other, Pediatrics

  Gandhi Medical College

• Other, Pediatrics

  William Beaumont Hospital

  2007

• Other, Pediatric Critical Care Medicine

  University of Utah

  2012

• Other, Pediatric Cardiology

  Duke University Medical Center

  2014