The Role of Outpatient Diuretic Therapy in Bronchopulmonary Dysplasia

门诊利尿疗法在支气管肺发育不良中的作用

基本信息

批准号：
10663469
负责人：
Joseph Michael Collaco
金额：
$ 10.05万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10663469
关键词：
2 year old Acute Adult Adverse effects Affect Alveolar Benefits and Risks Blood Vessels Breathing Bronchopulmonary Dysplasia Caring Child Childhood Chronic Clinic Clinical Data Development Diuretics Documentation Edema Educational workshop Electrolytes Emergency department visit Enrollment Gestational Age Goals Growth Guidelines Health Hospitals Impairment Infant Inpatients Intercellular Fluid Knowledge Life Light Live Birth Longevity Lung Lung diseases Measurement Mechanics Medical National Heart, Lung, and Blood Institute Neonatal Intensive Care Units Nephrocalcinosis Obstructive Lung Diseases Osteopenia Outcome Outpatients Patient-Focused Outcomes Pharmaceutical Preparations Premature Infant Pulmonary Hypertension Questionnaires Randomized, Controlled Trials Registries Research Research Personnel Respiratory Disease Respiratory Signs and Symptoms Role Severities Standardization Symptoms United States Variant Work of Breathing acute care age group chronic respiratory disease cohort examination questions experience hospital readmission improved infant outcome interstitial lung health lung injury premature prenatal pulmonary function respiratory respiratory morbidity side effect success tertiary care virtual

项目摘要

PROJECT SUMMARY More than 300,000 infants are born prematurely in the U.S. each year, and of these, approximately 50,000 develop chronic respiratory disease due to their prematurity. The most common respiratory manifestation is bronchopulmonary dysplasia (BPD), which affects alveolar, airway, and pulmonary vascular development. Limited data suggests that a substantial percentage of children with BPD will have long-term respiratory symptoms persisting into adult life with altered lung function trajectories. However, predicting the course of respiratory disease in children with BPD throughout the lifespan is currently difficult, compounded by the wide variation in outpatient management after initial hospital discharge. One of the most common types of medical management are diuretics. Theoretically, diuretics reduce interstitial fluid within the lungs, thus decreasing work of breathing. However, there is conflicting evidence regarding the benefits/risks of diuretic use within the neonatal intensive care unit, and virtually no data or guidelines for the use of these medications outside of the hospital. In light of the ongoing controversy that broad use of long-term diuretics in preterm infants may or may not be beneficial in the inpatient setting, our goal is to use “real-world” data to assess whether the outpatient use of diuretics reduce acute and chronic respiratory morbidities in preterm infants and young children less than 2 years of age and whether they are associated with the side effect of impaired growth. In Aim 1, we hypothesize that the use of diuretics during the first 2 years of life will result in less acute care use (e.g., emergency department visits and hospital readmissions) and decreased chronic respiratory symptoms (e.g., activity limitations and difficulty breathing). In Aim 2, we hypothesize that the use of diuretics during the first year after initial NICU discharge will result in impairment of growth. These studies will help direct our understanding and guidance for the use of outpatient diuretic use in children with BPD.

项目概要美国每年有超过 30 万婴儿早产，其中，大约 50,000 人因早产而患上慢性呼吸道疾病。常见的呼吸道表现是支气管肺发育不良（BPD），它影响肺泡，气道和肺血管发育有限的数据表明。患有 BPD 的儿童中长期呼吸道症状持续到成人的比例然而，肺功能轨迹改变的生活可以预测呼吸系统疾病的病程。目前，在患有 BPD 的儿童的整个生命周期中进行治疗是很困难的，而且广泛的初次出院后门诊管理的变化是最常见的情况之一。医疗管理的类型是利尿剂理论上，利尿剂可减少组织间液。肺部，从而减少呼吸功然而，存在相互矛盾的证据。新生儿重症监护病房内使用利尿剂的益处/风险，几乎没有数据或鉴于目前的情况，在医院外使用这些药物的指南。关于早产儿广泛使用长期利尿剂可能有益或无益的争议在住院环境中，我们的目标是使用“真实世界”数据来评估门诊患者是否使用利尿剂可减少早产儿和幼儿的急性和慢性呼吸道疾病 2岁以下的儿童以及他们是否与副作用有关在目标 1 中，我们勇敢地在生命的头 2 年内使用利尿剂。将导致急性护理使用减少（例如急诊科就诊和再入院）慢性呼吸道症状（例如活动限制和呼吸困难）减少。在目标 2 中，我们勇敢地在初始 NICU 后的第一年使用利尿剂这些研究将有助于指导我们的理解。以及 BPD 儿童门诊利尿剂的使用指南。