Imperial College London

Dr Padmanabhan Ramnarayan (Ram)

Faculty of MedicineDepartment of Surgery & Cancer

Reader in Paediatric Critical Care







508Medical SchoolSt Mary's Campus





I am a Clinical Reader in Paediatric Critical Care in the Department of Surgery and Cancer at Imperial College, Honorary Consultant in Paediatric Intensive Care at St Mary's Hospital, and Deputy Director of the Imperial Centre for Paediatrics and Child Health (PaeCH).

My main research interests are focused on pragmatic clinical trials (particularly related to paediatric ventilation), critical care epidemiology and the use of artificial intelligence (AI) to improve decision-making in critically ill children.

I graduated with an MBBS from JIPMER, Pondicherry University, India in 1995 and moved to the UK for postgraduate medical training. Following my MRCP (UK) degree, London in 1997, I completed postgraduate training in the North Thames Deanery from 1998-2005, obtaining a CCST in Paediatrics (Paediatric Intensive Care Medicine). My dual passion for research and information technology led me to take time out from clinical training between 2001 and 2004 to complete an MD(Res) in Medical Informatics Applications (University of London), during which I conducted a series of studies examining the accuracy and clinical utility of a computerised diagnostic decision support system called Isabel.

I continued doing clinical research while in a full-time NHS clinical post at Great Ormond Street Hospital (Children's Acute Transport Service) between 2005 and 2021, and established an internationally recognised track record of funded clinical research in paediatric critical care and emergency transport. I joined Imperial College as a clinical-academic in October 2021, working in Prof Anthony Gordon's (adult critical care) research group.

I am currently the Chair of the Paediatric Critical Care Society Study Group (PCCS-SG), a multidisciplinary group of UK paediatric critical care researchers.

In 2023, I was appointed Deputy Director of the Imperial Centre for Paediatrics and Child Health.

Research achievements

I have led several national studies funded by the National Institute of Health and Care Research (NIHR):

  • DEPICT (mixed methods study of the impact of timely access to intensive care for children): DEPICT was the largest ever study conducted in paediatric critical care transport. Findings influenced national quality standards for the care of critically ill children.
  • FIRST-ABC master protocol (noninvasive respiratory support in critically ill children): The two FIRST ABC clinical trials were the largest clinical trials ever conducted in paediatric noninvasive respiratory support, and influenced international guidelines.

I have co-led other impactful clinical trials in paediatric critical care:

  • CATCH (comparison of impregnated central venous catheters with standard catheters)
  • Oxy-PICU (conservative versus liberal oxygen saturation targets)
  • PRESSURE (permissive blood pressure target versus standard care).

I am currently:



Murali M, Ni M, Karbing DS, et al., 2024, Clinical practice, decision-making, and use of clinical decision support systems in invasive mechanical ventilation: a narrative review, British Journal of Anaesthesia, ISSN:0007-0912

Knight P, Norman V, Gully R, et al., 2024, Can critical care transport be safely reduced in children intubated during emergency management of status epilepticus in the United Kingdom: a national audit with case-control analysis., Arch Dis Child

Toader A-M, Campbell MK, Quint JK, et al., 2024, Using healthcare systems data for outcomes in clinical trials: issues to consider at the design stage., Trials, Vol:25

Peters MJ, Gould DW, Ray S, et al., 2023, Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial, The Lancet, ISSN:0140-6736

Evans REC, Barber V, Ramnarayan P, et al., 2023, Emergency Inter-Hospital Transfer of Children to PICUs in the United Kingdom: Qualitative Exploration of Parents' Experiences of Retrieval Teams, Pediatric Critical Care Medicine, Vol:24, ISSN:1529-7535, Pages:E476-E486

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