Non-invasive oscillometry to measure lung mechanics, response to treatments, and predict longer-term pulmonary outcomes among preterm infants: a prospective cohort study

无创示波法测量早产儿的肺力学、治疗反应并预测长期肺部结局：一项前瞻性队列研究

• 批准号: 10370156
• 负责人: Colm Peter Travers
• 金额: $ 16.71万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370156
• 关键词: Active Learning; Affect; Aftercare; Age; Anesthesia procedures; Area; Asthma; Beds; Birth; Breathing; Bronchopulmonary Dysplasia; Childhood; Clinical; Consumption; Control Groups; Development; Development Plans; Devices; Disease; Early Intervention; Early identification; Exhalation; Forced expiratory volume function; Frequencies; Furosemide; Future; Gestational Age; Goals; Health; Hospitals; Infant; Infant respiratory distress; Interruption; Intervention; Intervention Studies; Intervention Trial; Knowledge; Life; Lung; Lung diseases; Master of Science; Measures; Mechanics; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Morbidity - disease rate; Multi-Institutional Clinical Trial; Neonatal; Observational Study; Oscillometry; Outcome; Outcomes Research; Pharmaceutical Preparations; Pregnancy; Premature Birth; Premature Infant; Prospective cohort study; Public Health; Pulmonary function tests; Records; Reproducibility; Research; Research Methodology; Resistance; Risk; Scientist; Sedation procedure; Severity of illness; Side; Survivors; Techniques; Testing; Therapeutic Intervention; Time; Training; Vital capacity; Wheezing; Work; career; career development; clinical care; design; early childhood; experience; extreme prematurity; high risk; improved; innovation; insight; lung development; lung health; lung injury; neonate; novel; patient oriented research; postnatal; pulmonary function; research and development; respiratory; respiratory distress syndrome; respiratory morbidity; skills; tool; treatment response; ventilation

SUMMARY The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Colm Travers, MD, with the mentorship, training, and research experience needed to become an independent clinician scientist and leader in neonatal pulmonary outcomes research. His long-term career goal is to reduce the increasing burden of respiratory morbidity among the 360,000 survivors of preterm birth per year in the US through novel observational and interventional studies and large scale multi-center clinical trials of interventions that reduce lung injury. To achieve these goals and transition to independence, Dr. Travers and his mentors developed a comprehensive research and career development plan that includes mentorship from an exceptional team of scientists with proven track records of mentorship; intensive didactic training including completion of a Master of Science in Public Health in Outcomes Research; and a research plan that is purposefully designed to provide experiential learning in advanced research methods to study pulmonary outcomes among preterm infants. Survivors of preterm birth are at increased risk for wheeze, asthma, and abnormal pulmonary function tests (PFTs) during childhood. Studies of lung function in preterm infants have been limited by the difficulties with completing infant PFTs, restricting the ability to measure illness severity, assess response to treatments, and understand developmental lung health trajectories. Dr. Travers recently completed two prospective cohort studies using an innovative non-invasive oscillometry technique to quantify pulmonary mechanics in spontaneously breathing term and preterm infants. His early work observed that differences in lung mechanics between term and preterm infants can be reproducibly measured and persist until discharge. In the research plan outlined in this K23 proposal, Dr. Travers will expand upon this novel work, and his specific research aims are directly aligned with his training plan as follows: (1) To determine the extent to which differences in lung mechanics between healthy term infants and preterm infants with and without lung disease after birth persist until discharge from hospital or 40 weeks’ postmenstrual age, (2) To quantify changes in lung mechanics among preterm infants receiving medications for lung disease, and (3) To determine the extent to which abnormalities in pulmonary mechanics detected before discharge persist and predict longer-term pulmonary outcomes at 24 months. A non-invasive method to measure lung mechanics and predict longer-term pulmonary outcomes before discharge from hospital can fundamentally change our understanding of the effect of early postnatal lung development on lung function in preterm infants. In addition, a non-invasive bedside device that objectively measures response to treatments would be both a vital research and clinical tool. Building upon the skills and insights acquired through the proposed training and research plan, Dr. Travers will apply for an R01 to determine the effects of early interventions and therapies on lung mechanics and pulmonary health in early childhood.

概括 这个受过指导的以患者为导向的研究职业发展奖（K23）的目的是提供 医学博士科尔姆·特拉弗斯（Colm Travers），具有精神训练，培训和研究经验，需要成为一个 独立的临床科学家和新生儿肺结果研究的领导者。他的长期职业 目标是减少360,000次早产冲浪者中呼吸道发病率的增加 每年通过新的观察和介入研究以及大规模多中心临床 减少肺损伤的干预措施的试验。为了实现这些目标并过渡到独立性，博士 特拉弗斯及其导师制定了一项全面的研究和职业发展计划，包括 拥有庞大的科学家团队拥有庞大的遗传记录；密集的教学 培训，包括在结果研究中完成公共卫生科学硕士；和研究 计划旨在提供高级研究方法的专家学习来研究 早产儿的肺癌。早产的幸存者的轮子风险增加， 儿童期哮喘和异常肺功能测试（PFTS）。早产的肺功能研究 婴儿受到完成婴儿PFT的困难受到限制，从而限制了测量的能力 疾病的严重程度，评估对治疗的反应以及了解发育性肺部健康轨迹。博士 Travers最近使用创新的非侵入性振荡完成了两项前瞻性队列研究 在自发呼吸项和早产儿中量化肺力学的技术。他的早 工作观察到，学期和早产儿之间的肺力学差异可以重现 测量并持续直至排出。在此K23提案中概述的研究计划中，Travers博士将 扩展这项新颖的工作，他的具体研究目标直接与他的培训计划保持一致 以下内容：（1）确定健康期限婴儿肺力学差异的程度 出生后有和没有肺部疾病的早产儿都持续到出院或40周 月经后年龄，（2）量化接受药物的早产儿的肺力学变化 对于肺部疾病，（3）确定肺力学异常的程度 排出之前，并预测24个月的长期肺癌。一种非侵入性方法 测量肺力学并预测出院前的长期肺癌可以 从根本上改变我们对早期产后肺发育对肺功能的影响的理解 在早产婴儿中。另外，一种非侵入性床头设备，可以客观地衡量 治疗既是重要的研究和临床工具。基于获得的技能和见解 通过拟议的培训和研究计划，Travers博士将申请R01来确定效果 幼儿期肺部力学和肺部健康的早期干预和疗法。