The primary objective of this submission is to re-apply for designation as one of the centers selected to participate in the Network of Neonatal Intensive Care Units. The University of Miami's Division of Neonatology possesses an adequate clinical patient population, outstanding clinical, laboratory and research facilities, and competent, dedicated personnel. It has an extensive research experience in individual investigative work as well as in large collaborative multicenter clinical trials. The University of Miami has actively participated in the initial 5 year cycle of the NICU Network. Although consistently ranking third in number of low birth weight neonatal admissions, they have consistently ranked first in total numbers of infants randomized into the first major network trial on prophylactic intravenous immunoglobulin administration. They have extensive previous experience in other large multi-center successful clinical trials, such as prenatal glucocorticoid administration (NHLBI), high frequency ventilation (NHLBI. and the infant health and development program (Robert Wood Johnson). They are dedicated to the underlying goal of the Network which is to evaluate both the safety and efficacy of new therapeutic modalities using large multi-site randomized clinical trials, as opposed to limited personal experience or preference. The University of Miami has access to a large maternal-fetal-neonatal population approximating 14,000 live-born deliveries per year. In addition, it serves as the tertiary regional referral center for an area encompassing over 40,000 births and it receives out of county referrals from Central and South America and the Caribbean. The Neonatal Special Care Center routinely runs a census exceeding 120-130%. The high-risk team now includes over 200 full-time personnel whose work is exclusively devoted to neonates and their families. The neonatology faculty possess a wide range of expertise in areas of pulmonary and developmental medicine, substance abuse and infectious and central nervous system disorders. A longterm multi-disciplinary developmental evaluation and intervention program is directed by the proposed P.I. The University of Miami, with its commitment to relevant clinical research, its existing population, facilities and personnel, and its proven record of successful collaboration over the last decade, has a strong desire to continue in the Neonatal ICU Network and to contribute to effectively addressing the complex diagnostic and therapeutic problems of the newborn.
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