Patterned Experience for Preterm Infants

早产儿的模式化体验

• 批准号: 8627982
• 负责人: Rita H Pickler
• 金额: $ 39.74万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-03 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8627982
• 关键词: Acidosis; Address; Adult; Affect; Age; Apgar Score; Apolipoprotein E; Area; Behavior; Behavioral; Biological Markers; Biology; Birth; Brain; Brain Injuries; Caring; Cerebral Palsy; Characteristics; Clinical; Cognitive; Demographic Factors; Development; Diabetes Mellitus; Disease; Event; Feeding Patterns; Fetal Growth Retardation; Functional disorder; Genetic; Genetic Markers; Genotype; Goals; Health; Hospitalization; Hour; IL8 gene; Impairment; Infant; Infection of amniotic sac and membranes; Interferons; Interleukin-1; Interleukin-6; Intervention; Knowledge; Language; Learning; Length; Lesion; Life; Measures; National Institute of Nursing Research; Neonatal Intensive Care Units; Neurologic; Neuronal Plasticity; Neurons; Newborn Infant; Oral; Outcome; Pattern; Performance; Perinatal; Pregnancy; Premature Birth; Premature Infant; Premature Rupture Fetal Membranes; Randomized Controlled Trials; Risk; Sepsis; Steroids; Survival Rate; Synapses; Systems Development; TNF gene; Tactile; Testing; Time; Toddler; Touch sensation; Training; Very Low Birth Weight Infant; base; biobehavior; caregiving; cofactor; cognitive function; cost; cytokine; design; disability; experience; feeding; fetal; heart rate variability; improved; in utero; neurobehavioral; neuroprotection; parity; pregnancy hypertension; premature; public health relevance; relating to nervous system; skills; social; sucking; therapy design

DESCRIPTION (provided by applicant): The specific aim of this study is to test the effect of a patterned feeding experience (PFE) from birth to discharge from the neonatal intensive care unit (NICU) and beyond for infants born before 30 weeks gestation. The primary aim of this study is to test the effect of a PFE on neurobehavioral organization at three time points; the transition to oral feedings, NICU discharge, and 2 months corrected age (48 weeks PMA). The secondary aims are to test the effects of a PFE on cognitive function at 6 months corrected age, neurobehavioral development; and clinical outcomes. The study's exploratory aim is to describe the potential effects of demographic factors and biobehavioral cofactors on the outcome variables (neurobehavioral organization, cognitive function, neurobehavioral development, and clinical outcomes). It is hypothesized that infants who receive the PFE will have improved neurobehavioral organization, cognitive function, neurobehavioral development, and clinical outcomes in comparison to those who receive usual feeding care. A longitudinal, randomized control trial is proposed with two groups, one receiving a patterned feeding experience from the first gavage feeding through full oral feedings to discharge and one receiving usual feeding care experience. The intervention planned for this project is based on principles of neural plasticity and neuroprotection and is designed to take advantage of neuronal synaptic development and both experience-expectant and experience-dependent characteristics of the developing brain. In addition, the intervention is designed to take advantage of a regularly occurring caregiving and life sustaining event in the life of an infant, feeding. The intervention takes advantage of what we have learned about oral feeding experience in our previous studies, as well as what we have theoretically hypothesized is occurring in relation to the effect of patterned feeding. Thus, the patterned feeding experience intervention designed for this study involves a continuity of tactile experiences associated with feeding to train and build neuronal networks. This intervention provided a critical time in neurologic system development and associated with a recurring event (feeding) should enhance neural connections that may be important for later development, particularly language and other cognitive and neurobehavioral organization skills. The proposed study addresses the National Institute of Nursing Research's focus on the interplay of biology and behavior in an effort to promote health and limit disease. Consistent with NINR's goals, the intervention is based on well-defined underlying mechanisms and includes examination of genetic cofactors and other biomarkers implicated in poor neurobehavioral outcomes. Specifically the proposed study will investigate ways to ameliorate the long-term consequences of prematurity using a unique intervention that will easily adapt to caregiving the NICU.

描述（由申请人提供）：本研究的具体目的是测试模式化喂养体验 (PFE) 对妊娠 30 周前出生的婴儿从出生到出院新生儿重症监护病房 (NICU) 及之后的影响。本研究的主要目的是测试 PFE 在三个时间点对神经行为组织的影响；向经口喂养的过渡、NICU 出院和 2 个月校正年龄（48 周 PMA）。第二个目标是测试 PFE 对 6 个月校正年龄时的认知功能、神经行为发育的影响；和临床结果。该研究的探索性目的是描述人口因素和生物行为辅助因素对结果变量（神经行为组织、认知功能、神经行为发育和临床结果）的潜在影响。据推测，与接受常规喂养护理的婴儿相比，接受 PFE 的婴儿的神经行为组织、认知功能、神经行为发育和临床结果将得到改善。建议对两组进行纵向、随机对照试验，一组接受从第一次强饲喂养到完全口服喂养直至出院的模式化喂养体验，另一组接受常规喂养护理体验。该项目计划的干预措施基于神经可塑性和神经保护原理，旨在利用神经元突触发育以及发育中大脑的经验预期和经验依赖特征。此外，干预措施旨在利用婴儿生命中经常发生的护理和生命维持事件——喂养。该干预措施利用了我们在之前的研究中了解到的经口喂养经验，以及我们理论上假设的与模式喂养效果相关的情况。因此，为本研究设计的模式化喂养体验干预涉及与喂养相关的连续触觉体验，以训练和构建神经元网络。这种干预提供了神经系统发育的关键时期，并且与重复发生的事件（进食）相关，应该增强神经连接，这对于以后的发育可能很重要，特别是语言和其他认知和神经行为组织技能。这项拟议的研究涉及国家护理研究所对生物学和行为相互作用的关注，以促进健康和限制疾病。与 NINR 的目标一致，干预措施基于明确的潜在机制，包括检查与不良神经行为结果有关的遗传辅助因子和其他生物标志物。具体来说，拟议的研究将调查如何使用一种独特的干预措施来改善早产的长期后果，这种干预措施很容易适应新生儿重症监护室的护理。