This proposal is a reapplication from The University of Texas Southwestern Medical Center at Dallas to participate in the Cooperative Multicenter Neonatal Research Network (RFA: HD-00-010). Abbot R. Laptook, M.D. will serve as the Principal Investigator and the Alternate will be Walid A. Salhab, M.D. The primary teaching hospital of the UT Southwestern Medical Center is Parkland Hospital, which has the largest delivery population of any hospital in the United States. The Neonatal Intensive Care Unit (NICU) at Parkland has a bed capacity of 100 and is a state of the art facility. Adjoining Parkland Hospital is Children's Medical Center, which provides all needed specialized pediatric services for radiologic, operative, and cardiac procedures. There are a number of considerations that justify UT Southwestern continuing as one of the sites for the Network. First, a large inborn population is provided, and in spite of changes in health care delivery, Parkland Health and Hospital System has been able to maintain their delivery population, and admissions to the NICU have been relatively constant over the past decade. This reflects a well organized institutional approach to providing health care, and an established Obstetric service which is integrated within the health care delivery services of targeted communities of Dallas. Second, the UT Southwestern site offers ethnic diversity for the Network by providing a large number of Hispanic patients. Currently, the delivery population is 77% Hispanic and admissions to the NICU are 64% Hispanic. Third, the UT Southwestern site has a proven track record within the Network. It has been a member institution since the inception of the Network and continues to have a well organized system with a high percent of eligible infants enrolled in randomized trials, limited errors in conducting studies, complete data acquisition, and an almost 90% follow-up rate. Fourth, the PI provides expertise in cerebral metabolism and blood flow which will benefit the design and implementation of studies directed at perinatal brain damage. Finally, the Division of Neonatal-Perinatal Medicine at UT Southwestern has a strong commitment to clinical research and maintains a clinical management approach, which is reluctant to adopt new therapies without sufficient evaluation and evidence.
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