Respiratory function monitoring during resuscitation of extremely preterm infants: An ancillary study to the SAIL trial

极早产儿复苏期间的呼吸功能监测：SAIL 试验的辅助研究

基本信息

批准号：
9346640
负责人：
Elizabeth Foglia
金额：
$ 8.54万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-07 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9346640
关键词：
Acute Acute Lung Injury Ancillary Study Benefits and Risks Birth Breathing Bronchopulmonary Dysplasia Carbon Dioxide Cessation of life Characteristics Chest Chronic Clinical Data Delivery Rooms Economic Inflation Enrollment Environmental air flow Exhalation Failure Fetal Lung Functional Residual Capacity Funding Goals Hour Incidence Infant Intermittent Positive-Pressure Ventilation International Intratracheal Intubation Intubation Life Liquid substance Lung Masks Measures Mechanical ventilation Mechanics Methods Monitor National Institute of Child Health and Human Development Neonatal Newborn Infant Outcome Physiological Positive-Pressure Respiration Premature Infant Process Production Randomized Controlled Trials Research Research Priority Respiratory Mechanics Respiratory physiology Resuscitation Risk Site Study Subject Tidal Volume Time Volutrauma airway obstruction cohort effectiveness measure improved innovation lung injury neonatal resuscitation novel pressure prevent programs randomized trial respiratory surfactant tool

项目摘要

PROJECT SUMMARY/ABSTRACT Lung aeration is the most critical physiologic task for the preterm infant to achieve after birth for survival. Yet the optimal method of aerating the preterm lung remains unknown. After birth, the newborn must rapidly open the lungs to clear the fetal lung liquid and establish a Functional Residual Capacity (FRC). There are two strategies to achieve this goal: Intermittent Positive Pressure Ventilation (IPPV) with positive end expiratory pressure (PEEP), and Sustained inflation (SI). It is not yet known which strategy is superior for lung aeration after birth. Further, performing non-invasive (i.e., facemask) respiratory support is technically difficult in preterm infants. The impact of common problems, such as facemask leak and airway obstruction, on the need for rescue endotracheal intubation is unknown. The objectives of this project are to (1) assess the effect of SI and IPPV on direct measures of lung aeration, and (2) to determine the impact of measured respiratory mechanics, such as mask leak, airway obstruction, and delivered tidal volumes, on need for rescue intubation in extremely preterm infants during delivery room resuscitation. To accomplish these objectives, this proposal will use a respiratory function monitor (RFM) to directly measure indicators of lung aeration in preterm infants during delivery room resuscitation. A RFM is a novel research tool that measures and displays respiratory characteristics of delivered inflations in real time. This project is an ancillary study of the SAIL trial (Sustained Aeration of Infant Lungs, Clinicaltrials.gov identifier NCT02139800), an ongoing international randomized controlled trial of SI versus IPPV as the initial lung aeration strategy in extremely preterm infants. RFM is an innovative tool to measure pulmonary mechanics during delivery room resuscitation. The SAIL trial will be the largest randomized trial of SI versus IPPV performed in extremely preterm infants to date. This project will take advantage of the existing SAIL trial framework and use RFM to identify the optimal approach to aerate the preterm lung after birth.

项目概要/摘要肺通气是早产儿出生后生存所需完成的最关键的生理任务。然而为早产儿肺部通气的最佳方法仍然未知。出生后，新生儿必须迅速张开肺部以清除胎儿肺液体并建立功能残气量（FRC）。有两个实现这一目标的策略：呼气末正压间歇正压通气 (IPPV) 压力（PEEP）和持续通货膨胀（SI）。目前尚不清楚哪种策略对于肺部通气更优越出生后。此外，执行非侵入性（即面罩）呼吸支持在技术上很困难早产儿。常见问题（例如面罩泄漏和气道阻塞）对需求的影响气管插管用于抢救尚不清楚。该项目的目标是 (1) 评估 SI 和 IPPV 对肺通气直接测量的影响， (2) 确定测量的呼吸力学的影响，例如面罩泄漏、气道阻塞、和交付的潮气量，在产房期间需要对极度早产儿进行抢救插管时复苏。为了实现这些目标，该提案将使用呼吸功能监测仪（RFM）直接测量产房复苏期间早产儿肺通气指标。 RFM 是一项新颖的研究实时测量和显示所传递的充气的呼吸特征的工具。该项目是一个 SAIL 试验的辅助研究（婴儿肺持续通气，ClinicalTrials.gov 标识符 NCT02139800），一项正在进行的国际随机对照试验，比较 SI 与 IPPV 作为初始肺通气策略极早产儿。 RFM 是一种在产房复苏期间测量肺力学的创新工具。 SAIL试验这将是迄今为止在极早产儿中进行的最大规模的 SI 与 IPPV 随机试验。这项目将利用现有的 SAIL 试验框架并使用 RFM 来确定最佳方法出生后对早产儿肺进行通气。