Cervical (Neck) Auscultation and Developmental Outcomes

颈（颈）听诊和发育结果

• 批准号: 7144906
• 负责人: ERIC W REYNOLDS
• 金额: $ 10.8万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-27 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7144906
• 关键词: behavior test; bronchopulmonary dysplasia; clinical research; data collection methodology /evaluation; developmental neurobiology; disease /disorder proneness /risk; early /brief intervention /therapy; growth /development; human subject; human therapy evaluation; infant human (0-1 year); longitudinal human study; neck; oral behavior; outcomes research; premature infant human; prognosis; reflex; respiration regulatory center; swallowing; ultrasonography

DESCRIPTION (provided by applicant): Feeding is arguably the most complex skill a newborn infant must master in order to achieve independent survival. The integration of suck-swallow-breath rhythms is essential for development of effective feeding behavior. Patterns of suck-swallow-breath rhythms during feeding become more uniform as preterm infants grow and these rhythms are disrupted in infants with bronchopulmonary dysplasia (BPD). Inability to coordinate these rhythms may be a marker of poor neurologic outcome. Cervical auscultation (CA) with an accelerometer with digital signal processing (DSP) technology can be used to quantitatively compare the sounds of infant feeding by calculating the Variance Index (VI) of swallow-associated sounds. This method has been used to show that the swallow-associated sounds of low-risk preterm infants become more uniform with increasing post-menstrual age. As with other feeding rhythms, this progression is not seen in infants with BPD. No studies have correlated CA/DSP data with developmental outcomes. The objectives of this project are: 1) to identify factors inherent in the development of stability, and sources of variability, of swallow-associated sounds in infant feeding, 2) to correlate CA/DSP measurements of swallow-associated sounds during early rhythmic suckle feeding with long-term neurologic/developmental outcomes, 3) to identify differences in rhythmic suckle feeding of infants with various pathologic conditions and 4) to measure the effects of therapeutic interventions such as speech therapy on swallow-associated sounds. Objectives 1, 2 and 3 will be met with a prospective cohort study following 6 groups of infants, healthy term cohort, HIE term cohort, drug-exposed cohort, low-risk preterm cohort, BPD cohort and a Grade III/IVIVH cohort (n = 25 per group). The infants will be followed from the beginning of oral feeding to two years of life. CA/DSP and biometric data will be collected during feeding. Vis will be compared between groups at various time points and within each group over time. CA/DSP data will be correlated with neurobehavioral and developmental outcome data. By correlating the VI and other DSP parameters with behavioral and developmental data, CA/DSP data may be used to identify infants who are at higher risk of a poor long-term outcome, thus allowing earlier developmental intervention to take place. For objective 4, we will enroll an additional 25 infants with BPD and randomize the total group so that half of the infants (25) receive speech therapy and the other half do not. CA/DSP results will be compared before and after feeding therapy. We hypothesize that if therapy is successful, the VI for the intervention group will approximate the VI for the low-risk preterm infants. By successfully completing these projects, we will increase our understanding of the development of successful feeding behavior and make CA/DSP technology more available as a non-invasive diagnostic technique.

描述（由申请人提供）：喂养可以说是新生儿为了实现独立生存必须掌握的最复杂的技能。吸吮-吞咽-呼吸节律的整合对于有效进食行为的发展至关重要。随着早产儿的成长，喂养过程中吸吮-吞咽-呼吸节律的模式变得更加均匀，而这些节律在患有支气管肺发育不良（BPD）的婴儿中被破坏。无法协调这些节律可能是神经系统结果不佳的标志。带有数字信号处理（DSP）技术的加速度计的颈部听诊（CA）可通过计算吞咽相关声音的方差指数（VI）来定量比较婴儿喂养的声音。该方法已用于表明，随着经后年龄的增加，低风险早产儿的吞咽相关声音变得更加均匀。与其他喂养节律一样，患有 BPD 的婴儿不会出现这种进展。没有研究将 CA/DSP 数据与发育结果相关联。该项目的目标是：1) 确定婴儿喂养过程中吞咽相关声音的稳定性发展和变异性来源的固有因素​​，2) 将早期有节奏吸奶期间吞咽相关声音的 CA/DSP 测量值关联起来喂养与长期神经/发育结果相关，3）确定患有各种病理状况的婴儿的节律性吸奶喂养的差异，4）测量治疗干预措施（例如言语治疗）对吞咽相关声音的影响。目标 1、2 和 3 将通过一项前瞻性队列研究来实现，该研究跟踪 6 组婴儿、健康足月队列、HIE 足月队列、药物暴露队列、低风险早产队列、BPD 队列和 III/IVIVH 队列（n = 每组 25 个）。将对婴儿进行从开始经口喂养到两岁的追踪。 CA/DSP 和生物识别数据将在喂食期间收集。将在不同时间点的组之间以及随着时间的推移每组内部进行 Vis 比较。 CA/DSP 数据将与神经行为和发育结果数据相关。通过将 VI 和其他 DSP 参数与行为和发育数据相关联，CA/DSP 数据可用于识别长期不良结果风险较高的婴儿，从而可以进行更早的发育干预。对于目标 4，我们将另外招募 25 名患有 BPD 的婴儿，并对整个组进行随机分组，以便一半婴儿 (25) 接受言语治疗，另一半则不接受。 CA/DSP 结果将在喂养治疗之前和之后进行比较。我们假设，如果治疗成功，干预组的 VI 将接近低风险早产儿的 VI。通过成功完成这些项目，我们将加深对成功喂养行为发展的理解，并使 CA/DSP 技术更容易成为一种非侵入性诊断技术。