ULTRASOUND AND VENTILATOR STUDIES IN PRETERM INFANTS

早产儿的超声和呼吸机研究

• 批准号: 2198291
• 负责人: THOMAS E WISWELL
• 金额: $ 25.59万
• 依托单位: THOMAS JEFFERSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-08-01 至 1996-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2198291
• 关键词: ULTRASOUND; VENTILATOR; STUDIES; PRETERM; INFANTS

Preterm infants requiring ventilatory support because of respiratory distress syndrome (RDS) will be randomly assigned to either conventional ventilation (CV) or high frequency jet ventilation (HFJV) during a 5-year longitudinal study. In all ventilated infants and in randomly selected non-ventilated infants (NV) with no or mild RDS, serial cranial ultrasound (US) studies which do not interfere with intensive care management will be performed shortly after birth and then every 48 to 72 hours until ventilatory support is discontinued. US studies will then be obtained in all survivors at 7 to 14 day intervals until discharge, and all images will be independently interpreted by 2 of the investigators, both of whom are blinded as to the treatment group (CV, HFJV or NV). The US images will be graded for intracranial hemorrhage (ICH), periventricular echodensity (PVE), and periventricular cysts (PCs) and measured for ventricular size (VS) and brain/cranial growth according to our previously established protocol. Color Doppler imaging (CDI), which depicts blood flow in color and anatomy in black and white, will be used to measure flow velocity and pulsatility of the cerebral arteries in randomly selected infants from all three groups (CV, HFJV and NV). Infants treated by CV and HFJV will be studied with CDI while on assisted ventilation and again after ventilatory support has been discontinued. The goals of this application, a continuation and extension of our present research, is to compare the relationship of two types of assisted ventilation (CV and HFJV) to brain disorders as ascertained by neonatal cranial US and CDI studies and by neurodevelopmental assessments during early childhood. The proposed research in preterm infants will test the following hypotheses: 1. Are neurosonographic abnormalities (ICH,PV,PC) more frequent or more severe in infants treated with CV than in those treated with HFJV? 2. Are cerebral growth and ventricular size as measured by cranial US correlated with type of ventilation or with perinatal complications and variables independent of type of ventilation? 3. Are cerebral blood flow patterns, velocity, and pulsatility as determined by CDI correlated with type of ventilation or with US abnormalities or with both? 4. Are measures of early development independent of the subject's SES profile correlated with type of ventilation? Our studies completed during the past three years have defined the prognostic significance of various US abnormalities through the early pre- school period. As part of this continuation proposal we plan to continue developmental studies on our previously enrolled prematurely born subjects.

由于呼吸系统而需要通气支持的早产儿 遇险综合征（RDS）将随机分配给任何一个常规 5年期间的通风（CV）或高频喷气通风（HFJV） 纵向研究。 在所有通风婴儿中，随机选择 无或轻度RD的非通风婴儿（NV），连续颅超声 （美国）不干扰重症监护管理的研究将是 出生后不久进行一次，然后每48至72小时 通风支撑被停产。 然后将获得美国的研究 所有幸存者以7至14天的间隔为止，直到出院为止，所有图像将 由2个调查人员独立解释 对治疗组（CV，HFJV或NV）蒙蔽。 美国图像将是 分级用于颅内出血（ICH），脑室脑周围回声密度 （PVE）和脑室周围囊肿（PC），并针对心室尺寸进行测量 （VS）和大脑/颅骨生长，根据我们先前确定的 协议。 颜色多普勒成像（CDI），描绘了彩色的血液 黑白解剖学将用于测量流速和 从所有人中随机选择的婴儿中脑动脉的脉动性 三组（CV，HFJV和NV）。 由简历和HFJV治疗的婴儿将是 在辅助通风时与CDI一起研究，并在通风后再次研究 支持已经停止。 该应用程序的目标，我们现在的延续和扩展 研究是为了比较两种辅助类型的关系 如新生儿确定的通风（CV和HFJV）对脑疾病 美国和CDI研究以及通过神经发育评估 幼儿。 提议的早产儿将测试 以下假设： 1。是神经发表异常（ICH，PV，PC）更频繁或更频繁 用简历治疗的婴儿严重比接受HFJV治疗的婴儿严重？ 2。是颅美国测量的大脑生长和心室大小 与通风类型或围产期相关 并发症和变量独立于通风类型？ 3。是脑血流模式，速度和搏动性 由CDI确定与通风类型相关或与我们相关 异常还是两者？ 4。是独立于主题的SES的早期发展的度量 轮廓与通风类型相关？ 我们过去三年完成的研究定义了 美国各种异常的预后意义。 学校时期。 作为该延续建议的一部分，我们计划继续 关于我们以前入学的过早出生的学科的发展研究。