Hibbs -Association Between Intermittent Hypoxia and Later Respiratory Morbidity

希布斯 - 间歇性缺氧与后期呼吸系统疾病之间的关联

• 批准号: 9763640
• 负责人: Anna Maria Hibbs
• 金额: $ 56.89万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763640
• 关键词: Age; Age-Months; Animal Model; Apnea; Asthma; Basic Science; Biochemical Markers; Biological Markers; Biomedical Engineering; Blood specimen; Breathing; Clinical; Clinical Trials; Collection; Data; Data Collection; Development; Disease; Enrollment; Environmental air flow; Event; Frequencies; Future; Gestational Age; Goals; Hospitalization; Hypoxia; Impairment; Incidence; Infant; Intervention; Lead; Length; Length of Stay; Life; Link; Lung; Measurement; Measures; Morbidity - disease rate; Mus; Neonatal; Neonatal Apneic Attack; Outcome; Oxidative Stress; Oxygen; Oxygen Therapy Care; Pathway interactions; Pattern; Pharmaceutical Preparations; Pregnancy; Premature Birth; Premature Infant; Prospective cohort study; Pulse Oximetry; Recovery; Research Personnel; Resistance; Resolution; Respiratory System; Retinopathy of Prematurity; Retrospective cohort; Risk; Rodent; Role; Serotonergic System; Serotonin; Signal Transduction; Smooth Muscle Actin Staining Method; Structure; Symptoms; Time; Urine; Wheezing; Work; cohort; experience; falls; follow-up; high risk; high risk population; improved; lung injury; meetings; novel; oxidant stress; oxidation; postnatal; premature; respiratory; respiratory smooth muscle; time interval

Project Summary Longer term respiratory morbidity remains a major consequence of preterm birth. We seek to characterize the association between immature respiratory control manifest as intermittent hypoxia [IH] and later respiratory morbidity in a cohort of preterm infants less than or equal to 30 weeks' gestation. Our hypotheses in Aims 1 and 2 are that IH episodes at one week and one month of life are significantly associated with prolonged duration of hospitalization and respiratory support, as well as a high incidence of wheezing disorders by six months adjusted age. In Aim 3 we hypothesize that low serotonin levels are associated with a high incidence of IH and a prolonged recovery of respiratory effort after onset of desaturation. Finally, in Aim 4 we hypothesize a temporal relationship between IH episodes and markers of oxidative stress determined by urine and blood samples. In prior studies we have demonstrated that apnea almost always precedes desaturation in preterm infants and have documented a novel association between retinopathy of prematurity, and both the duration of IH events and the time interval between IH events. From these data we speculate that it is both longer IH events and a distinct time interval of at least one minute between IH events that will be associated with respiratory morbidity and accompanying oxidative stress. This proposal provides a unique opportunity to quantify, for the first time, a relationship between IH and biomarkers of oxidation. We provide additional retrospective data that IH is associated with both increased length of stay and postnatal wheezing disorders, as well as a remarkable track record for both meeting enrollment goals and effective follow-up in prior clinical trials. Additionally, we have a strong track record for collection of continuous cardiorespiratory waveforms with bioengineering expertise in signal acquisition and processing that is ideally suited for multicenter data collection. In conclusion, our investigators' expertise in the measurement and analysis of respiratory and saturation waveforms, characterization of IH events, the basic science of respiratory control, and the measurement of clinical respiratory outcomes, makes us ideally poised to execute this single center, as well as multisite, proposal.

项目摘要 长期呼吸道发病仍然是早产的主要结果。我们寻求 表征未成熟呼吸控制表现为间歇性的关联 缺氧[IH]和后来的呼吸道发病率小于或等于30 妊娠周。我们在目标1和2中的假设是IH情节一周，一个 生命月与长时间的住院持续时间显着相关 呼吸支持以及调整六个月的喘息疾病的高发病率很高 年龄。在AIM 3中，我们假设低血清素水平与高发生率有关 IH并在去饱和开始后长期恢复呼吸道努力。最后，在目标4中我们 假设IH发作与氧化应激标记之间的时间关系 由尿液和血液样本确定。在先前的研究中，我们证明了呼吸暂停 几乎总是先于早产儿的饱和度，并记录了一本小说 早产视网膜病变与IH事件的持续时间之间的关联 IH事件之间的间隔。从这些数据中，我们推测它都是IH事件的更长的事件和 在IH事件之间至少一分钟的不同时间间隔将与 呼吸道发病率和伴随的氧化应激。该建议提供了独特的 首次量化IH与氧化生物标志物之间的关系的机会。 我们提供其他回顾性数据，IH与增加的住院时间相关 和产后喘息的疾病，以及两个会议的杰出记录 在先前的临床试验中，入学目标和有效的随访。此外，我们有一个强大的 通过生物工程收集连续心肺波形的记录 在信号获取和处理方面的专业知识非常适合多中心数据 收藏。总之，我们的调查人员在测量和分析方面的专业知识 呼吸和饱和波形，IH事件的表征，基础科学 呼吸控制以及临床呼吸结局的测量，使我们理想地 准备执行这个单一中心以及多站点的建议。