• Early TNE evaluation of Ultra-Low Birth Weight Infants during the Transitional Period and Physiology Guided Management
• Hemodynamic Effects of Late Surfactant in ELBW infants
• Early Prediction of PDA in ELBW infants
• Retinopathy of Prematurity and PDA
• Impact of Hemodynamic Consultation in US NICU
• Impact of Early PDA screening on care of babies less than 27 weeks’ gestation
• Predictive analytics in prevention of morbidities in ELBW infants
• Right Ventricular Function and Hypoxic-Ischemic Encephalopathy
• Right ventricular function in the setting of Congenital Diaphragmatic Hernia
• Nitric Oxide Responsiveness and myocardial function in acute Pulmonary Hypertension
• Role of Echocardiography simulator in neonatal training
• Role of inhaled epoprostenol in pulmonary vascular disease and chronic pulmonary hypertension

• Assessment of right ventricle-pulmonary vascular coupling physiology and importance in acquired and congenital heart disease
• Acute care physiology in relation to necrotizing enterocolitis in the neonatal and cardiac intensive care units
• Management of hemodynamic compromise in neonates suffering from hypoxic ischemic encephalopathy

• Comparing cord milking to early cord clamping in term non-vigorous infants (MINVI trial).
• Comparing delayed cord clamping to umbilical cord milking in preterm infants (PREMOD2 trial).
• Comparing empiric antibiotic therapy to placebo in extremely low birthweight infants (NANO trial).
• Comparing early CPAP to early minimal invasive surfactant administration (LISA) in preterm infants.
• Evaluating the use of Sodium Cromolyn therapy in preterm infants to reduce BPD,
• Comparing the effectiveness of nasal high flow cannula to CPAP using Electrical Impedance Tomography.

• Normative Echocardiographic Values for Right and Left Ventricular Function in Extremely Premature Neonates

• Early prediction of spontaneous patent ductus arteriosus closure and PDA-associated outcomes
• Impact of gestational age and perinatal factors on cardiac function in extremely preterm infants
• The role of milrinone in neonates with persistent pulmonary hypertension unresponsive to inhaled nitric oxide
• Prediction of inhaled nitric oxide responsiveness in pulmonary hypertension
• Patent Ductus Arteriosus Closure and PDA-Associated Outcomes
• Regulation of PDE3 in the Pathobiology of Pulmonary Hypertension
• PIVOTAL: Percutaneous Intervention Versus Observational Trial of Arterial Ductus in Low Weight Infants

• Racial disparities in development of chronic pulmonary hypertension
• Differential mi-RNA expression in VLBWs with and without Pulmonary hypertension from Birth to discharge

• Targeted brain oxygenation
• Impact of echocardiographic measures of pulmonary hypertension, shunting patterns, and ventricular dysfunction on the outcome of
• Milrinone in CDH trial

• Safety, preliminary effectiveness and pharmacokinetics of Sildenafil in premature infants at risk of BPD
• NICHD Neonatal Research Network trials: Management of PDA and Milrinone in CHD

• Milrinone in Congenital diaphragmatic Hernia. NICHD Neonatal Research Network (PI: María Victoria Fraga , MD)
• Nitric Oxide responsivity in infants with Severe Chronic Lung Disease (PI: María Victoria Fraga, MD)
• Point-of-care ultrasound for evaluation of ECMO cannula position in neonates (Lead: Thomas Pawlowski, MD)

• Participating site in the Preliminary Percutaneous intervention versus Observational Trial of Arterial Ductus in Low-weight Infants (PIVOTAL)
• Participating site in the VentFirst Study
• Founding member of the Delivery Room Intervention and Evaluation (DRIVE) Network
• Patent Ductus Arteriosus Assessment with Objective Measures

• Early targeted treatment of PDA in high risk preterm infants based on a risk severity score
• Pulmonary hemodynamics and cardiac function in children with trisomy 21
• Adjunctive role of milrinone in management of pulmonary hypertension in term and near term infants
• Role of deformation imaging in delineating cardiovascular phenotype in neonatal disease states
• Impact of gestational age and neonatal morbidities on cardiovascular development in premature infants

• Baby OSCAR Trial
• RePHiNe- International Neonatal Pulmonary Hypertension Registry
• A comparison of two iNO dosing regimens

• Application of advanced functional echocardiography in neonatal disease
• Cardiac dysfunction and pulmonary hypertension in congenital diaphragmatic hernia
• Assessment and management of patent ductus arteriosus
• Multi-modal haemodynamic assessment to guide targeted management in term and preterm
• Optimal management of the umbilical cord, with bedside stabilisation, in preterm infant and relationship to haemodynamic transition
• The impact of cerebral NIRS on perinatal management of extremely preterm infants

• Randomized double blind multicenter phase III clinical trial for evaluating two strategies for treating ductus arteriosus echocardiographically guided with ibuprofen: impact on the bowel prognosis
• SafeBoosC III (Safeguarding the brain of our smallest children)
• Neoflow (systemic flow assessed with NPE during transitional circulation)
• Online cerebral pressure autoregulation continuous monitoring as a neurobiomarker to guide assessment and intervention to prevent or minimize brain injury in the high-risk preterm infant
• NEO-CIRC-003. An International multicenter randomized placebo-controlled, double blind three arm trial to investigate the efficacy of dobutamine with two different starting doses in the treatment of haemodynamic insufficiency in the immediate postnatal period.

• EDSCINI Study (Early Detection of Shock in Critically Ill Newborn Infants)
• BeNeDuctus Trial (International multi-centre,randomised non-inferiority trial of early treatment versus expectative management of patent ductus arteriosus in preterm infants).
• Companion (Comprehensive haemodynamic monitoring of the newborn)

• Lungs and heart interaction in preterm infants with chronic lung disease: the ultrasound perspective
• Application of advanced functional echocardiography in preterm infants with chronic lung disease
• Measure of non-invasive marker of pulmonary function in preterm infants with chronic lung disease

• Atrial strain as normal value and in pathological conditions
• Interaction between hemodynamics and lung ultrasound score

• Atrial deformation in the neonate: a mirror of ventricular function? (PI: Benjamim Ficial)
• Ultrasound SVC flow quantification: validation of a modified technique (PI: Benjamim Ficial)
• Atrial function in neonates with TTN: a prospective observational case-control study (PI: Benjamim Ficial)
• SVC flow and blood flow volume in extracerebral arteries (PI: Benjamim Ficial)

The newborn services at Manchester have a dedicated research unit led by research lead Dr. Mukherjee, consultant neonatologist. Several portfolio studies are undertaken like SURFON study, ALLIANCE study, NEOVANC Study, Cool cuddle 2 study etc. The following studies are ongoing:

1. Paracetamol and Ibuprofen Research Pilot trial (PAIR) – Dr. Arin Mukherjee (CI)
2. WHEAT Trial – Blood Transfusion during feeding - Dr. Ruth Gottstein (PI)
3. DOLFIN- HIE - Dr. Aparajita Basu (PI)
4. FOOTPRINTS – biomarkers for CLD
5. NEOGASTIC – Measuring routine gastric residuals – Dr. Tom Hogan (PI)

• There are two multicentre randomised controlled trials ongoing within the neonatal unit evaluating different interventions for management of the PDA. These are Treocapa and ETAPA.
• Two observational studies are ongoing addressing transition in the delivery room and the second evaluating BPD associated PH.

• Effects of packed red blood cell Transfusion on Hemodynamics and tissue OxygenationS in preterm infants (ETHOS) study
• Utilizing Precision Medicine (Single-cell RNA Sequencing and Advance Hemodynamic Monitoring) Approach to Predict the Outcome in Late Onset Neonatal Sepsis?
• U-Premier Study for Neonatal Sepsis
• Art of Precision Medicine (Whole Genome, Transcriptome, Methylome, Metabolome, and Advance Hemodynamic Monitoring) for Early Prediction of Outcome in Neonatal Congenital Diaphragmatic Hernia, APPLLE study for CDH

• Sidra Institutional Research Fund (IRF)
• Qatar National Research Fund (QNRF)

• Cardiac remodeling after preterm birth: Exploring the pathophysiology behind changes in cardiac shape and size after preterm birth.
• Intracardiac blood flow studies: using blood speckle imaging to help understand myocardial function and energetics.
• Left ventricular diastolic function in preterm infants: clinical and echocardiography studies to help detail diastolic function.
• Sepsis and septic shock: understanding hemodynamics and ultrasound methods to guide treatments.

Main areas of research: Perinatal transition, fetal growth restriction, bronchopulmonary dysplasia, Cardiac remodelling and adaptation after severe fetal growth restriction, PLUSS Echo trial.

• Novel ultrasound quantification techniques for evaluating organ perfusion
• Application of four-dimensional ultrasound techniques in newborn care

• RPA has an extensive history of neonatal haemodynamic research with numerous publications from the department including research correlating TNE findings to clinical outcomes as well as randomised controlled trials.
• Current Neonatal haemodynamic research is focused on outcomes of infants born prematurely using aortic intima-media thickness.

• Hemodynamics in congenital diaphragmatic hernia
• NIRTURE Study: A multicentre randomised controlled trial in premature babies (<29 weeks gestation at birth). Research question: Can using a dedicated treatment using cerebral oxygenation monitoring (NIRs) compared to usual treatment reduce the burden of cerebral hypoxia and hyperoxia in the first 5 days? Chief Investigator: Dr Himanshu Popat.
• Acute pulmonary hypertension in term and preterm neonates
• Hemodynamic management of neonates referred for ECMO
• Hemodynamics and outcomes following surgical PDA closure (ligation and transcatheter closure)

The Royal Women’s Hospital Melbourne is involved in lung and cardiac research. Currently a participating site for the PLUSS Trial (Preventing Lung Disease Using Surfactant + Steroid) looking at PDA assessment and treatment after intratracheal steroid and surfactant. Ongoing research utilising Lung USS for extubation and lung recruitment.