Patterns of Hypoxia and Mortality in the SUPPORT Trial Cohort

支持试验队列中的缺氧和死亡率模式

• 批准号: 8759060
• 负责人: RICHARD JOHN MARTIN
• 金额: $ 7.93万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8759060
• 关键词: Address; Area Under Curve; Cardiovascular system; Cessation of life; Clinical; Data; Descriptor; Early identification; Enrollment; Event; Exposure to; Future; Hyperoxia; Hypoxia; Incidence; Infant; Infant Mortality; Intention; Intervention; Lead; Life; Measurement; Modeling; Morbidity - disease rate; Neonatal Mortality; Oxidative Stress; Oxygen; Pattern; Play; Population; Premature Infant; Pulse Oximetry; Randomized; Regulation; Retinopathy of Prematurity; Risk; Rodent Model; Role; Severities; Stratification; Supplementation; Survivors; Techniques; Therapeutic; Time; Variant; Visual impairment; base; biological adaptation to stress; cohort; computer program; design; high risk; improved; infant death; infant morbidity; insight; mortality; neonate; novel; postnatal; pressure; public health relevance; randomized trial; respiratory; surfactant; time interval

DESCRIPTION (provided by applicant): The use of supplemental oxygen in preterm infants continues to be a challenge as sustained low and high oxygen, and fluctuations in oxygen have been implicated in infant morbidity. In a large multi-center trial (Surfactant, Positive Pressure, and Oxygenation Randomized Trial or SUPPORT), preterm infants randomized to a low level of oxygen revealed an unexpected increase in infant mortality. In addition, data in a subcohort of infants enrolled in the trial showed a higher incidence of fluctuations in oxygen levels, or intermittent hypoxia (IH) events, in the low oxygen saturation target group. Therefore, although the cause for the increased infant mortality is unknown, intermittent hypoxia may have played a key role. Our objective for this proposal is to quantify patterns (incidence, duration, severity an timing) of intermittent hypoxia and their interaction with baseline oxygen saturation in infants who died compared to infants who survived. Existing continuous pulse oximetry recordings from the SUPPORT trial will be reviewed for infants who died and compared to SUPPORT trial infants who survived. A novel computer program and techniques developed by our group will be used to analyze both baseline oxygen saturation and the incidence and patterns of oxygen fluctuations on a daily basis to identify variations in oxygenation associated with infant mortalit. Early identification of risk patterns of oxygen fluctuations may lead to timely intervention to reduce infant mortality in this high risk cohort.

描述（由申请人提供）：在早产儿中使用补充氧气仍然是一个挑战，因为持续的低氧气和高氧气，氧气的波动与婴儿的发病率有关。在一项大型多中心试验（表面活性剂，正压和氧合随机试验或支持）中，早产婴儿随机分配至低氧气，发现婴儿死亡率意外增加。此外，在低氧气饱和靶标组中，在试验中注册的婴儿的亚群中的数据显示，氧气水平或间歇性缺氧（IH）事件的发生率更高。因此，尽管婴儿死亡率增加的原因尚不清楚，但间歇性缺氧可能发挥了关键作用。我们对该提案的目标是量化间歇性缺氧的模式（持续时间，严重性）及其与与存活的婴儿相比，死亡的婴儿中与基线氧饱和的相互作用。支持试验的现有连续脉搏血氧仪记录将对死亡的婴儿进行审查，并将其与生存的支持婴儿进行比较。我们组开发的一种新型计算机程序和技术将用于分析基线氧饱和度以及每天的氧气波动的发生率和模式，以鉴定与婴儿凡人相关的氧合变化。早期鉴定氧气波动的风险模式可能会导致及时干预以降低这种高风险队列的婴儿死亡率。