The last decade has witnessed exponential growth in the field of Neonatal Hemodynamics and functional echocardiography in neonatal intensive care units, driven in response to the need for improvement in understanding and management of the rapidly changing cardiovascular physiology in critically ill neonates. The limited exposure to quality education in neonatal cardiovascular physiology during neonatal-perinatal medicine training has been raised as a major concern by trainees. In addition, the absence of scientific validation of measures of cardiovascular function in newborns and lack of standardized integration of echocardiography techniques in research design further hinders diagnostic precision and optimization of therapeutic interventions. Optimal use of echocardiography may enable better appraisal of ambient physiology, provide key mechanistic insights, enhance phenotypic characterization, and facilitate the investigation of disease/physiology-specific pharmacological interventions.
Therefore, the Neonatal Hemodynamic Research Center (NHRC) was envisioned to establish an independent platform to increase the scientific and educational engagements between hemodynamics researchers, expert hemodynamic clinicians and upcoming faculty and trainees in academic programs globally. The independent nature and virtual design enable the NHRC to transcend regional and geographical barriers.
The overarching mandate of the NHRC is to advance the field of neonatal cardiovascular ultrasound and improve lives through excellence in education, research, innovation, advocacy, and service to the profession and the public. The vision of NHRC is to create an international network of thought leaders in neonatal hemodynamics and foster high-quality collaborative education, research, and quality improvement work. Content delivery through global education rounds, physiology-based case reviews and online workshops/courses ensures broad dissemination of knowledge and scientific updates to trainees, neonatologists, sonographers, and cardiologists. It is also the vision of NHRC to establish structured review processes for research ideas, grants and publications which will enhance the quality of support and mentorship for clinicians pursuing hemodynamic sciences. Finally, the NHRC strives to play an important advocacy role in the establishment and accreditation of new clinical programs, and facilitate future expansion of the field.
All material on or available through this website, including text, data, images, and illustrations, (collectively, the "Material") is owned, controlled, or licensed by NHRC. NHRC grants you license to visit, view, and retain a copy of the educational materials available on this website for your own personal, non-commercial use only. You may link to or frame the Material, the website, or any portion thereof, for educational or training purposes only. You may not copy or imitate the "look and feel" of the website, or any portions thereof, for any reason.
Users of our site can submit content for publication in various areas of our site. You will be deemed to consent to these guidelines, and these terms and conditions, if you choose to post any content or comments to our site. When you submit content to us, you agree and represent that you have created that content, or you have received permission from, or are authorised by, the owner of any part of the content to submit it to our site. By submitting content to us, you are granting us an unconditional, irrevocable, non-exclusive, royalty-free, fully transferable, perpetual worldwide licence to use, publish and/or transmit, and to authorise third-parties to use, publish and/or transmit your content in any format and on any platform.
We, or authorised third parties, reserve the right to modify, edit or refuse to publish, your content at our or their sole discretion. We may remove your content from use at any time. You acknowledge and agree that when you post content to our site or view content provided by others, you are doing so at your own discretion and risk, including any reliance on the accuracy, completeness, of that content.
We accept no liability in respect of any content submitted by users and published by us or by authorised third parties.
You will defend, indemnify, and hold NHRC or its agents harmless from your use of and access of the website.
In no event will NHRC or its agents be liable for any indirect, special, consequential, incidental or punitive damages arising out of your access to, or use of, this website or the content or materials therein, whether in a contract action or based on negligence, or other tort action, or any other claim whatsoever, even if NHRC has been advised of the possibility of such damages.
The Neonatal Hemodynamics Research Center wishes to acknowledge the uniquely brilliant career of Dr Regan Giesinger. Regan completed her training in neonatal-perinatal medicine and neonatal hemodynamics at the University of Toronto. She was appointed as Assistant Professor of Pediatrics and Staff Neonatologist at SickKids hospital, Toronto in 2015. Thereafter, she was appointed Director of one of the world’s leading neonatal hemodynamics programs and Associate Professor of Pediatrics at the University of Iowa in 2018. Although quiet and humble in every encounter, Regan’s intelligence and quick thinking intimidated many. She recognized that if we are to provide the “best” care, there was an urgent need to re-engage with physiology and in providing the “right” therapy, clinicians needed to recognize the importance of diagnostic precision and delineation of the specific phenotype. Regan’s dedication to patients and their families was second to none.
Regan was an exceptional young clinician scientist, who at a very early stage of her career, achieved an international reputation in her chosen field of neonatal hemodynamics and the application of targeted neonatal echocardiography (TNE) as a critical bedside tool to enhance clinical care and research through the provision of enhanced diagnostic and mechanistic insights. Although her career was cut short, she made substantial scientific contributions including 65 original articles, 11 book chapters, and numerous abstracts. She also served as a co-investigator on several National Institute of Health (NIH) grants. Her primary research work, which characterized the relationship between right ventricular dysfunction and neurodevelopmental outcomes in term neonates with hypoxic ischemic encephalopathy, was precedent setting and has laid the foundation for further investigations aimed at improving the outcomes for this vulnerable population of neonates. She also published several original contributions related to novel therapies in pulmonary hypertension, and the use of nitric oxide in preterm infants. In addition, she delivered more than 100 invited talks across the world, including the United States, Canada, Sweden, Romania, Italy, India, and the UK. She was honored with delivering the 2020 Neonatal Hemodynamics club lecture at PAS. Regan showed outstanding strength, integrity and leadership in education, training and administrative roles, and represented the very best of academic medicine. She was a member of the Neonatal Hemodynamics Advisory at PAS and was an executive member of the Neonatal Hemodynamics and TNE specialty interest group at the American Society of Echocardiography. In 2021, Regan was appointed as fellow of the American Society of Echocardiography (FASE), making her one of the few neonatologists to receive this accolade.
I would say her greatest achievement has been re-shaping the minds of so many young trainees and building the culture of the hemodynamics movement in Neonatology. Regan was a deep thinker, and time spent reflecting on complex patients, gaps in scientific knowledge or debating optimal hemodynamic care was when she flourished. Her landmark publication in the Blue Journal on the beneficial impact of hemodynamic screening on outcomes in extremely preterm babies is transformative. Sadly, Regan passed away from us after an extensive battle with cancer on May 16th, 2023. She has left behind a powerful legacy. In teaching the importance of physiology and diagnostic precision in cardiovascular care, Regan has influenced a generation of trainees and young faculty. Her contributions in the field of neonatal hemodynamics will continue to guide us for years to come.
Dr. Patrick J McNamara
On behalf of the Neonatal Hemodynamics Program, University of Iowa and
Neonatal Hemodynamics Research Centre
NPA: Dr. Amish Jain
Funding: Heart & Stroke Ontario Clinician Scientist (Phase II) Award
The focus of the IMPRINT research program is to improve the clinical care and reduce the burden of pulmonary heart disease in preterm neonates suffering from pulmonary hypertension. The program’s current studies are:
Prospective observational study to develop robust echocardiographic criteria for early identification of preterm infants at risk of developing chronic pulmonary hypertension PMID: 33789855 | DOI: 10.1136/bmjopen-2020-044924
Funding: Canadian Institutes of Health Research (IHDCYH)–SickKids Foundation Participating sites: 6 NHRC sites across Canada, the United States & Europe
A detailed registry of preterm neonates treated with inhaled nitric oxide Funding: Mallinckrodt Investigator Initiated Research Grant Participating sites: 12 Canadian NHRC sites
NPA: Dr. Dany Weisz
PA: Dr. Amish Jain, Dr. Luc Mertens, Dr. Prakesh Shah
The main objective of this study is to develop an outcome-based definition of ‘significant’ PDA among extremely low gestational age neonates at different postnatal ages. Funding: Canadian Institutes of Health Research Project Grant Participating sites: 17 Canadian NHRC sites
NPA: Dr. Souvik Mitra
PA: Dr. Amish Jain, Dr. Prakesh Shah
The main objective of this registry-based comparative effectiveness research study is to compare the different pharmacotherapeutic practices aimed at closure of patent ductus arteriosus and to evaluate their impact on clinical outcomes in extremely preterm infants (<29 weeks GA) . Funding: Canadian Institutes of Health Research Project Grant Participating sites: 22 Canadian sites
NPA: Dr. Joseph Ting
Participating sites: BC Women’s Hospital and Health Centre & University of Iowa Stead Family Children’s Hospital
NPA: Audrey Hebert
Participating sites: CHU de Québec-Université Laval & University of Iowa Stead Family Children’s Hospital
Click here to read!
Case Report 7: A case of neonatal dilated cardiomyopathy and congenital hydrocephalus
Authors: Laura Wilson, Catalina Bazacliu and J. Lauren Ruoss (Divisions of Neonatology & Cardiology, University of Florida Gainesville & Division of Neonatology, Orlando Health Regional Medical Center)