- Overview
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Critical care decisions in the smallest and sickest newborns are often based on research that has rarely included such critically ill babies and has seldom explored outcomes that actually matter to families. As a neonatologist caring for the tiniest and most vulnerable humans, my research program aims to address these knowledge gaps through multicenter clinical trials and to incorporate the principles of practice of ‘evidence-based medicine’ in their care.
- Publications
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Advocating for drug development in newborn infants
Early Human Development
Karel Allegaert and Souvik Mitra and Anne Smits and Mark A. Turner
DOI: 10.1016/j.earlhumdev.2024.106136
12/2024Prophylactic cyclo-oxygenase inhibitor drugs for the prevention of morbidity and mortality in extremely preterm infants: a clinical practice guideline incorporating family values and preferences
Archives of Disease in Childhood: Fetal and Neonatal Edition
DOI: 10.1136/archdischild-2023-325445
2024Selective early medical treatment of the patent ductus arteriosus in extremely low gestational age infants: a pilot randomised controlled trial protocol (SMART-PDA)
BMJ Open
DOI: 10.1136/bmjopen-2024-087998
2024Practice recommendations regarding parental presence in NICUs during pandemics caused by respiratory pathogens like COVID-19
Frontiers in Pediatrics
DOI: 10.3389/fped.2024.1390209
2024Procedural closure of the patent ductus arteriosus in preterm infants: a clinical practice guideline
Journal of Perinatology
DOI: 10.1038/s41372-024-02052-9
2024Lack of Blinding May Affect Objective Outcomes in Trials on Neonatal Ventilation
Neonatology
DOI: 10.1159/000540604
2024Sustained inflation and chest compression versus 3:1 chest compression to ventilation ratio during cardiopulmonary resuscitation of asphyxiated newborns (SURV1VE): A cluster randomised controlled trial
Archives of Disease in Childhood: Fetal and Neonatal Edition
DOI: 10.1136/archdischild-2023-326383
2024Inhaled nitric oxide use in newborns
Paediatrics & Child Health
Souvik Mitra and Gabriel Altit
DOI: 10.1093/pch/pxac107
05/2023Invasive management for patent ductus arteriosus in preterm infants
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD014862
2023Acetaminophen for the patent ductus arteriosus: has safety been adequately demonstrated?
Journal of Perinatology
Wright, C.J. and McCulley, D.J. and Mitra, S. and Jensen, E.A.
DOI: 10.1038/s41372-023-01697-2
2023Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD013588.pub2
2023EBNEO Commentary: Precision management of the patent ductus arteriosus in micropreemies
Acta Paediatrica, International Journal of Paediatrics
DOI: 10.1111/apa.16853
2023Evaluation of Health-Related Values and Preferences of Adults Who Were Preterm Infants and Parents of Preterm Infants Concerning Use of Prophylactic Cyclooxygenase Inhibitor Drugs
JAMA Network Open
Mitra, S. and Hatfield, T. and Campbell-Yeo, M. and Dorling, J. and Johnston, B.C.
DOI: 10.1001/jamanetworkopen.2023.2273
2023Methylxanthine for preventing morbidity and mortality in preterm infants: a network meta-analysis
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD015058
2023Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants
Cochrane Database of Systematic Reviews
MacLellan, A. and Cameron, A.J. and Cooper, C. and Mitra, S.
DOI: 10.1002/14651858.CD015424
2022Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants
Cochrane Database of Systematic Reviews
Jasani, B. and Mitra, S. and Shah, P.S.
DOI: 10.1002/14651858.CD010061.pub5
2022Variability in the diagnostic and management practices of post-hemorrhagic ventricular dilatation in very preterm infants across Canadian centers and comparison with European practices
Journal of Neonatal-Perinatal Medicine
Afifi, J. and Leijser, L.M. and De Vries, L.S. and Shah, P.S. and Mitra, S. and Brouwer, M.J. and Walling, S. and McNeely, P.D.
DOI: 10.3233/NPM-221071
2022EBNEO Commentary: A network meta-analysis of postnatal corticosteroids for bronchopulmonary dysplasia: Has the most appropriate treatment been revealed?
Acta Paediatrica, International Journal of Paediatrics
Bamat, N.A. and Jensen, E.A. and Mitra, S.
DOI: 10.1111/apa.16228
2022Care of the critically ill neonate with hypoxemic respiratory failure and acute pulmonary hypertension: framework for practice based on consensus opinion of neonatal hemodynamics working group
Journal of Perinatology
Jain, A. and Giesinger, R.E. and Dakshinamurti, S. and ElSayed, Y. and Jankov, R.P. and Weisz, D.E. and Lakshminrusimha, S. and Mitra, S. and Mazwi, M.L. and Ting, J. and Narvey, M. and McNamara, P.J.
DOI: 10.1038/s41372-021-01296-z
2022A conversation on evidence-based medicine in the COVID-era, patient revolution, and academic career with Dr. Victor Montori
Journal of Evidence-Based Medicine
Mitra, S. and Boasquevisque, D.D.S. and Noorduyn, S. and Rodrigues, M. and Lawson, D.O. and Thabane, L. and Montori, V.
DOI: 10.1111/jebm.12487
2022Prophylactic cyclo-oxygenase inhibitor drugs for the prevention of morbidity and mortality in preterm infants: a network meta-analysis
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD013846
2021Automated control of fraction of inspired oxygen: Is it time for widespread adoption?
Current Opinion in Pediatrics
Mitra, S. and McMillan, D.
DOI: 10.1097/MOP.0000000000000993
2021Epidemiology and Outcomes of Infants with Hypoxemic Respiratory Failure
Hypoxic Respiratory Failure in the Newborn: From Origins to Clinical Management
DOI: 10.1201/9780367494018-29
2021Comparison of standard versus high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus in preterm infants
Journal of Perinatology
Hillier, K. and Jones, K. and MacInnis, M. and Mitra, S.
DOI: 10.1038/s41372-021-01046-1
2021Relative effectiveness and safety of pharmacotherapeutic agents for patent ductus arteriosus (PDA) in preterm infants: A protocol for a multicentre comparative effectiveness study (CANRxPDA)
BMJ Open
Mitra, S. and Jain, A. and Ting, J.Y. and Ben Fadel, N. and Drolet, C. and Abou Mehrem, A. and Soraisham, A. and Jasani, B. and Louis, D. and Lapointe, A. and Dorling, J. and Khurshid, F. and Hyderi, A. and Kumaran, K. and Bodani, J. and Weisz, D. and Alvaro, R. and Adie, M. and Stavel, M. and Morin, A. and Bhattacharya, S. and Kanungo, J. and Canning, R. and Ye, X.Y. and Hatfield, T. and Gardner, C.E. and Shah, P.
DOI: 10.1136/bmjopen-2021-050682
2021Optimizing practice guidelines through incorporating patient and family values and preferences
Seminars in Fetal and Neonatal Medicine
Mitra, S. and Dorling, J. and Johnston, B.C.
DOI: 10.1016/j.siny.2021.101194
2021Building a community of practice through social media using the hashtag #neoEBM
PLoS ONE
Keir, A. and Bamat, N. and Hennebry, B. and King, B. and Patel, R. and Wright, C. and Scrivens, A. and ElKhateeb, O. and Mitra, S. and Roland, D.
DOI: 10.1371/journal.pone.0252472
2021Patent Ductus Arteriosus—Time for a Definitive Trial
Clinics in Perinatology
Mitra, S. and McNamara, P.J.
DOI: 10.1016/j.clp.2020.05.007
2020Effect of Fentanyl Boluses on Cerebral Oxygenation and Hemodynamics in Preterm Infants: A Prospective Observational Study
Neonatology
Mitra, S. and Babadagli, M.E. and Hatfield, T. and Depalma, A. and McCord, H. and El-Naggar, W. and Schm{\"o}lzer, G.M. and McMillan, D.D.
DOI: 10.1159/000508555
2020Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD013278.pub2
2020Anti-inflammatory medications for obstructive sleep apnoea in children
Cochrane Database of Systematic Reviews
Kuhle, S. and Hoffmann, D.U. and Mitra, S. and Urschitz, M.S.
DOI: 10.1002/14651858.CD007074.pub3
2020Epidemiology of thrombosis in Canadian neonatal intensive care units
Journal of Perinatology
El-Naggar, W. and Yoon, E.W. and McMillan, D. and Afifi, J. and Mitra, S. and Singh, B. and da Silva, O. and Lee, S.K. and Shah, P.S.
DOI: 10.1038/s41372-020-0678-1
2020Are neonatal clinical practice guidelines truly evidence-based? A case for incorporating family values and preferences
Acta Paediatrica, International Journal of Paediatrics
Mitra, S. and Reid, M. and McDougall, B. and Johnston, B.C.
DOI: 10.1111/apa.14879
2019Palivizumab for children with Down syndrome: Is the time right for a universal recommendation?
Archives of Disease in Childhood
Paes, B. and Mitra, S.
DOI: 10.1136/archdischild-2018-316408
2019High continuous positive airway pressure in neonates: A physiological study
Pediatric Pulmonology
Mukerji, A. and Wahab, M.G.A. and Mitra, S. and Mondal, T. and Paterson, D. and Beck, J. and Fusch, C.
DOI: 10.1002/ppul.24312
2019Probiotics for preterm infants: A National Retrospective Cohort Study
Journal of Perinatology
Singh, B. and Shah, P.S. and Afifi, J. and Simpson, C.D. and Mitra, S. and Dow, K. and El-Naggar, W.
DOI: 10.1038/s41372-019-0315-z
2019Delivery room interventions to prevent bronchopulmonary dysplasia in preterm infants: A protocol for a systematic review and network meta-analysis
BMJ Open
Mitra, S. and Disher, T. and Pichler, G. and D{'}Souza, B. and McCord, H. and Chayapathi, V. and Jones, K. and Schm{\"o}lzer, G.
DOI: 10.1136/bmjopen-2018-028066
2019Cerebral regional tissue Oxygen Saturation to Guide Oxygen Delivery in preterm neonates during immediate transition after birth (COSGOD III): An investigator-initiated, randomized, multi-center, multi-national, clinical trial on additional cerebral tissue oxygen saturation monitoring combined with defined treatment guidelines versus standard monitoring and treatment as usual in premature infants d
Trials
Pichler, G. and Baumgartner, S. and Biermayr, M. and Dempsey, E. and Fuchs, H. and Goos, T.G. and Lista, G. and Lorenz, L. and Karpinski, L. and Mitra, S. and Kornhauser-Cerar, L. and Avian, A. and Urlesberger, B. and Schm{\"o}lzer, G.M.
DOI: 10.1186/s13063-019-3258-y
2019Association of placebo, indomethacin, ibuprofen, and acetaminophen with closure of hemodynamically significant patent ductus arteriosus in preterm infants a systematic review and meta-analysis
JAMA - Journal of the American Medical Association
Mitra, S. and Florez, I.D. and Tamayo, M.E. and Mbuagbaw, L. and Vanniyasingam, T. and Veroniki, A.A. and Zea, A.M. and Zhang, Y. and Sadeghirad, B. and Thabane, L.
DOI: 10.1001/jama.2018.1896
2018Automated versus manual control of inspired oxygen to target oxygen saturation in preterm infants: A systematic review and meta-analysis
Journal of Perinatology
Mitra, S. and Singh, B. and El-Naggar, W. and McMillan, D.D.
DOI: 10.1038/s41372-017-0037-z
2018Indomethacin for symptomatic patent ductus arteriosus in preterm infants
Cochrane Database of Systematic Reviews
DOI: 10.1002/14651858.CD013133
2018Pain-relieving interventions for retinopathy of prematurity: A meta-analysis
Pediatrics
Disher, T. and Cameron, C. and Mitra, S. and Cathcart, K. and Campbell-Yeo, M.
DOI: 10.1542/peds.2018-0401
2018Hospitalization for Respiratory Syncytial Virus in Children with Down Syndrome Less than 2 Years of Age: A Systematic Review and Meta-Analysis
Journal of Pediatrics
Mitra, S. and El Azrak, M. and McCord, H. and Paes, B.A.
DOI: 10.1016/j.jpeds.2018.08.006
2018Source and Quality of Enteral Nutrition Influences Oxidative Stress in Preterm Infants: A Prospective Cohort Study
Journal of Parenteral and Enteral Nutrition
Fusch, G. and Mitra, S. and Topp, H. and Agarwal, A. and Yiu, S.H. and Bruhs, J. and Rochow, N. and Lange, A. and Heckmann, M. and Fusch, C.
DOI: 10.1002/jpen.1156
2018The association of platelets with failed patent ductus arteriosus closure after a primary course of indomethacin or ibuprofen: a systematic review and meta-analysis
Journal of Maternal-Fetal and Neonatal Medicine
Mitra, S. and Chan, A.K. and Paes, B.A.
DOI: 10.3109/14767058.2016.1163684
2017Effectiveness and safety of treatments used for the management of patent ductus arteriosus (PDA) in preterm infants: A protocol for a systematic review and network meta-analysis
BMJ Open
Mitra, S. and Florez, I.D. and Tamayo, M.E. and Aune, D. and Mbuagbaw, L. and Veroniki, A.-A. and Thabane, L.
DOI: 10.1136/bmjopen-2016-011271
2016Target fortification of breast milk: Levels of fat, protein or lactose are not related
Acta Paediatrica, International Journal of Paediatrics
Fusch, G. and Mitra, S. and Rochow, N. and Fusch, C.
DOI: 10.1111/apa.12804
2015Chorioamnionitis as a Risk factor for retinopathy of prematurity: A systematic review and meta-analysis
Neonatology
Mitra, S. and Aune, D. and Speer, C.P. and Saugstad, O.D.
DOI: 10.1159/000357556
2014Remission of congenital complete heart block without anti-Ro/La antibodies: A case report
Annals of Pediatric Cardiology
Mitra, S. and Saha, A.K. and Sardar, S.K. and Singh, A.K.
DOI: 10.4103/0974-2069.115278
2013Management of patent ductus arteriosus in preterm infants-where do we stand?
Congenital Heart Disease
Mitra, S. and R?nnestad, A. and Holmstr?m, H.
DOI: 10.1111/chd.12143
2013Measuring new born foot length to identify small babies in need of extra care: A cross-sectional hospital based study
Iranian Journal of Pediatrics
Mukherjee, S. and Roy, P. and Mitra, S. and Samanta, M. and Chatterjee, S.
2013Can cormic index be a marker of pubertal onset and progress?
Journal of Tropical Pediatrics
Mitra, S. and Samanta, M. and Sarkar, M. and Roy, P. and Chatterjee, S.
DOI: 10.1093/tropej/fmr092
2012Changing clinical profile of Dengue infection: A newer perspective in the pediatric population
Journal of Pediatric Infectious Diseases
Mukherjee, S. and Mitra, S. and Samanta, M. and Roy, P. and Sarkar, M. and Chatterjee, S.
DOI: 10.3233/JPI-2012-0339
2012Developing nomogram to estimate birth weight from head circumference and mid-upper arm circumference
Journal of Tropical Pediatrics
Das, S. and Ghosh, M. and Mitra, S. and Chatterjee, R. and Bhattacharyya, S. and De, A.K. and Chakraborty, S.
DOI: 10.1093/tropej/fmr080
2012Pre-exchange 5% albumin infusion in low birth weight neonates with intensive phototherapy failure-A randomized controlled trial
Journal of Tropical Pediatrics
Mitra, S. and Samanta, M. and Sarkar, M. and De, A.K. and Chatterjee, S.
DOI: 10.1093/tropej/fmq083
2011Foot length as a marker of pubertal onset
Indian Pediatrics
Mitra, S. and Samanta, M. and Sarkar, M. and Chatterjee, S.
DOI: 10.1007/s13312-011-0092-z
2011Dorfman-Chanarin syndrome: A rare neutral lipid storage disease
Indian Journal of Pathology and Microbiology
Mitra, S. and Samanta, M. and Sarkar, M. and Chatterjee, S.
DOI: 10.4103/0377-4929.72098
2010 - Research
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Current Projects
Patent ductus arteriosus (PDA) is one of the common most cardiovascular problems in babies born extremely premature. Controversy exists on when to treat a PDA, if at all, and what is the safest and most effective medication to treat a PDA in extremely preterm infants. My current research program explores different aspects of this problem through the following projects:
1. Selective Early Medical Treatment of the Patent Ductus Arteriosus in Extremely Low Gestational Age Infants: A Pilot Randomized Controlled Trial (the SMART PDA Trial)
This is a multicenter, multinational randomized controlled trial that exclusively enrolls babies born below 26 weeks of gestational age with the overarching goal to explore if selective early medical therapy of a moderate-severe PDA shunt identified based on pre-defined clinical signs & routine screening echocardiography improves clinically meaningful outcomes. This study is funded by the CIHR Early Career Investigators in Maternal, Reproductive, Child and Youth Health Grant 2020.
2. Relative effectiveness and safety of pharmacotherapeutic agents for treatment patent ductus arteriosus(PDA) in preterm infants: A National Comparative Effectiveness Research (CER) Project
This is a multicenter prospective observational study conducted through the Canadian Neonatal Network across 20 Canadian neonatal intensive care units that explores which of the commonly used prostaglandin-inhibitor regimens is the safest and most effective in treating a PDA in extremely preterm infants. This study is funded by the CIHR Fall 2019 Project Grant.
3. Evidence synthesis on PDA management in preterm infants – Cochrane Database of Systematic Reviews
With over 80 randomized controlled trials on this topic, rigorous synthesis of the existing evidence is essential for developing trustworthy clinical practice guidelines. My research team including students, colleagues and collaborators are currently involved in or have recently contributed to several Cochrane systematic reviews on PDA management:
a. Early treatment versus expectant management of hemodynamically significant patent ductus arteriosus for preterm infants
b. Feeding during treatment of patent ductus arteriosus
c. Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants
d. Indomethacin for symptomatic patent ductus arteriosus in preterm infants
e. Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews
f. Invasive management for patent ductus arteriosus in preterm infants
g. Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants
h. Prophylactic cyclo-oxygenase inhibitor drugs for the prevention of morbidity and mortality in preterm infants: a network meta-analysisGrants2021/4 – 2024/3: Project title: Selective Early Medical Treatment of the Patent Ductus Arteriosus in Extremely Low Gestational Age Infants: A Pilot Randomized Controlled Trial (the SMART PDA Trial). Funding Source: Canadian Institutes of Health Research (CIHR) Early Career Investigators in Maternal, Reproductive, Child and Youth Health Grant 2020 (Principal Investigator). Total Funding – $208,998 (Canadian dollar) [including 1:1 matching fund support from the Dalhousie Medical Research Foundation; IWK Health Research; Department of Pediatrics, Dalhousie University]
2020/1 – 2024/1: Project title: Relative effectiveness and safety of pharmacotherapeutic agents for treatment patent ductus arteriosus (PDA) in preterm infants: A National Comparative Effectiveness Research (CER) Project. Funding Source: Canadian Institutes of Health Research (CIHR) Project Grant Fall 2019 (Principal Investigator). Total Funding – $313,652 (Canadian dollar)
2022/9 – 2025/8. Project title: Increasing capacity for Maternal and PAediatric Clinical Trials (IMPACT) in Canada. Principal Applicant: Dr. Lauren Kelly, Associate Professor, Depts. of Pharmacology and Therapeutics, and Community Health Sciences, University of Manitoba. Funding Source: CIHR Training Grant: Clinical Trials Training Platforms (Co-Investigator). Total Funding – $ 4,907,350 (Canadian dollar)
2022/9 – 2025/8. Project title: Increasing capacity for Maternal and PAediatric Clinical Trials (IMPACT) in Canada. Principal Applicant: Dr. Jean Bourbeau, Research Institute at McGill University Health Centre. Funding Source: CIHR Training Grant: Clinical Trials Training Platforms (Co-Investigator). Total Funding – $ 11.3M (Canadian dollar)
2022/4 – 2027/3. Project title: Dopamine vs. Norepinephrine for hypotension in very preterm infants with late-onset sepsis: A National Comparative Effectiveness Research (CER) Project. Principal Applicant: Dr. Amish Jain, Associate Professor, University of Toronto. Funding Source: Canadian Institutes of Health Research (CIHR) Project Grant Fall 2021 (Co-Investigator). Total Funding – $ 473,761 (Canadian dollar)
2021/6 – 2022/5. Project title: Parental presence restrictions due to COVID-19: Examining impact and priorities for neonatal care (The PRESENCE Study). Principal Applicant: Dr. Marsha Campbell-Yeo, Professor, Dalhousie University. Funding Source: Canadian Institutes of Health Research (CIHR) Emerging COVID-19 Research Gaps and Priorities Funding Opportunity (Co-Investigator). Total Funding – $193,100 (Canadian dollar)
2021/1 – 2025/1: Project title: REdefining the SignificancE and Treatment threshold for Patent Ductus Arteriosus in preterm infants (RESET-PDA). Principal Applicant: Dr. Dany Weisz, Assistant Professor, University of Toronto. Funding Source: Canadian Institutes of Health Research (CIHR) Project Grant Fall 2020 (Co-Investigator). Total Funding – $566,100 (Canadian dollar)
Honours & Awards2022/11 – Recipient of the Emerging Professional Award at the 2022 Discovery Awards for Science and Innovation: Discovery Centre, Nova Scotia
2022/5 – Invited panelist on "Game Changers in Health Research and Health Innovation" event: Parliamentary Health Research Caucus, Research Canada
2020/12 – Department of Pediatrics Research Award for Research Excellence [Category: In the first 10 years of an academic appointment], Department of Pediatrics, Dalhousie University
2020/12 – 2021 CNPRM (Canadian National Perinatal Research Meeting) Early Career Researcher Invited Lectureship
2019/6 – Rising Star Award: Canadian Child Health Clinician Scientist Program (CCHCSP), Toronto, ON
2019/5 – Richard Merritt Special Appreciation Award: Canadian Society of Hospital Pharmacists, Ottawa, ON
Research Group MembersMichelle Avina, Research Assistant
Uthaya Kanagaraj, Neonatal Hemodynamics and Targeted Neonatal Echocardiography Fellow
Lindsay Richter, Research Manager
Una Spasovski, Graduate Research Assistant
Torin Halvorson and Hebah Hussaina awarded Vanier scholarships for immunotherapy and mental health research
BC Children’s Hospital Research Institute (BCCHR) is proud to announce that two of its outstanding research trainees, Torin Halvorson, an MD/PhD student working with the Levings research team, and Hebah Hussaina, a graduate research assistant in the Brussoni Lab, have been awarded the prestigious 2024 Vanier Canada Graduate Scholarship.
