Pathophysiology of Aerodigestive Reflexes in Infants

婴儿呼吸消化反射的病理生理学

• 批准号: 7103299
• 负责人: Sudarshan R Jadcherla
• 金额: $ 29.65万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7103299
• 关键词: acidity /alkalinity; age difference; child physical development; clinical research; epiglottis; gastrointestinal motility /pressure; human subject; infant human (0-1 year); longitudinal human study; mechanoreceptors; neuroregulation; oral behavior; pathologic process; patient oriented research; premature infant human; reflux esophagitis; respiratory airflow disorder; respiratory airflow measurement; respiratory airway pressure; respiratory reflex; sensorimotor system; sleep; vagus nerve; wakefulness

DESCRIPTION (provided by applicant): Independent feeding and breathing skills are the two important functions for survival in human infants. Feeding difficulties coupled with airway-related complications in infants contribute significantly to infant mortality and morbidity. Lack of a proper understanding of the physiology and pathophysiology of reflexes protective against aspiration during health or disease in developing infants is a fundamental problem that challenges management strategies. Our long-term goal is to develop evidence-based safe feeding strategies in infants at-risk. The current objective is to define the normal development as a basis for understanding abnormality of the sensory-motor neural and muscular control of foregut motility and aerodigestive tract defense mechanisms in human infants. There is a critical need for safety-ensured mechanistic studies that will provide a solid foundation for the management of feeding and airway safety in (1) healthy premature infants and in conditions such as (2) GERD and (3) neurological disease. In aim 1, peristaltic reflexes induced by esophageal stimulation in preterm healthy infants in sleep and awake states are investigated. In aim 2, the relationship of GERD on reflux clearance- and glottal closure- reflexes and comparison with healthy controls are investigated. In aim 3, the effects of neurological malfunction on aerodigestive protective mechanisms and comparison with healthy controls are investigated. Using safety packed, cutting-edge techniques and micromanometry system and novel pharyngo-esophageal manometry catheters, synchronized and integrated respiratory measurements, we will evaluate the sensory and motor elements of the peristaltic reflexes in premature infants, GERD, and neurological illness. In addition, we will evaluate airway protective reflexes with concurrent ultrasound. ANOVA, multiple logistic regression and student's t- test will be used. The new information will create a context for understanding sensory-motor-pathways involved with peristaltic reflexes and airway safety; thus providing a basis for future clinical care or trials.

描述（由申请人提供）：独立的喂养和呼吸技巧是人类婴儿生存的两个重要功能。喂养困难以及婴儿与气道相关并发症的喂养困难对婴儿的死亡率和发病率显着贡献。缺乏对反射性保护性的生理学和病理生理学在发展中的疾病或疾病期间的反射性保护性，这是挑战管理策略的基本问题。我们的长期目标是制定婴儿身高的循证安全喂养策略。当前的目的是将正常发展定义为理解人类婴儿中前进运动和机动道防护机制的感觉运动神经和肌肉控制的异常的基础。对安全确定的机械研究的迫切需要，该研究将为（1）健康的早产儿和（2）GERD和（3）神经系统疾病等疾病中的喂养和气道安全提供坚实的基础。在AIM 1中，研究了在睡眠和清醒状态的早产儿中食管刺激引起的蠕动反射。在AIM 2中，研究了GERD在回流清除率和闭合闭合的关系 - 与健康对照组的比较。在AIM 3中，研究了神经功能故障对机制保护机制的影响以及与健康对照组的比较。使用安全填充的，尖端的技术和微观管理系统以及新型的pharyngo-噬菌体测压导管，同步和集成的呼吸测量，我们将评估早期婴儿，GERD和神经系统疾病中蠕动反射的感觉和运动元素。此外，我们将通过并发超声评估气道保护反射。将使用方差分析，多个逻辑回归和学生的T-测试。新信息将创建一个环境，以理解与蠕动反射和气道安全有关的感觉运动通道；因此为将来的临床护理或试验提供了基础。