Oxygenation instability and maturation of control of breathing in evolving BPD.

不断发展的 BPD 中的氧合不稳定和呼吸控制的成熟。

• 批准号: 9336169
• 负责人: EDUARDO H BANCALARI
• 金额: $ 57.8万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 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/9336169
• 关键词: Abdomen; Abdominal Muscles; Affect; Age; Animals; Apnea; Birth; Blood; Breathing; Bronchopulmonary Dysplasia; Chronic lung disease; Clinical; Clinical Research; Complex; Continuous Positive Airway Pressure; Development; Exhalation; Exposure to; Frequencies; Goals; Guidelines; Hypercapnic respiratory failure; Hyperoxia; Hypoxemia; Hypoxia; Impairment; Infant; Infant Care; Knowledge; Lead; Lung; Lung diseases; Mechanical ventilation; Muscle Contraction; Neonatal; Neonatology; Observational Study; Oxygen; Population; Premature Infant; Prevalence; Prevention strategy; Prospective Studies; Respiratory Failure; Respiratory Mechanics; Respiratory System; Respiratory physiology; Risk; Secondary to; Severities; Supplementation; System; Time; Universities; Variant; Vulnerable Populations; animal data; cohort; extreme prematurity; improved; lung development; lung maturation; lung volume; medical schools; pediatric department; postnatal; premature; programs; prospective; respiratory; respiratory oxygen; treatment strategy

PROJECT SUMMARY This is the application from the Division of Neonatology - Department of Pediatrics, University of Miami Miller School of Medicine for participation as a Clinical Research Center in the Prematurity-Related Ventilatory Control (Pre-Vent) cooperative program. Part of this proposal is a prospective study titled “Oxygenation instability and maturation of control of breathing in evolving BPD”. Most extreme premature infants present with respiratory failure due to altered lung function compounded by breathing instability due to an immature respiratory control function. A significant proportion of these infants end up with abnormal lung development and bronchopulmonary dysplasia (BPD). Premature infants at risk for BPD present with significant oxygenation instability in the form of frequent spontaneous episodes of hypoxemia during the first weeks after birth. As a result, these infants receive oxygen supplementation but this is often excessive and these infants are also exposed to hyperoxemia. This is of great concern because studies in experimental animals have shown that exposure to intermittent hypoxia and hyperoxia can alter the normal development of their control of breathing system and contribute to respiratory instability. The extent to which these episodes of hypoxemia or the exposure to hyperoxemia impact on the maturation of the control of breathing system in extreme premature infants during the evolving stages of BPD is unknown. We propose a prospective study that will systematically evaluate such association in extreme premature infants at risk for BPD. The main objective of this study is to determine the extent to which exposure to frequent episodes of hypoxemia and hyperoxemia in extreme premature infants during the early stages of their chronic lung disease is associated with altered maturation and function of their respiratory control system. The causes for the altered maturation of the system that controls breathing in extreme premature infants with BPD are complex and not well understood and this hinders our ability to improve the care of these infants. Our overall goal is to participate in the Pre-Vent cooperative program and contribute to a better understanding of the factors that cause respiratory and oxygenation instability in premature infants with lung disease. Through this improved knowledge we expect to identify more effective preventive and treatment strategies for this vulnerable population.

项目概要 这是迈阿密米勒大学儿科新生儿科的申请 医学院作为早产儿相关通气临床研究中心参与 该提案的一部分是一项名为“氧合”的前瞻性研究。 不断发展的 BPD 中呼吸控制的不稳定和成熟”。 大多数极端早产儿因肺功能障碍而出现呼吸衰竭 这些婴儿中很大一部分因呼吸控制功能不成熟而导致呼吸不稳定。 最终出现肺部发育异常和支气管肺发育不良（BPD）的早产儿。 BPD 表现为明显的氧合不稳定，表现为频繁自发性低氧血症发作 因此，这些婴儿在出生后的最初几周内会接受氧气补充，但这通常是很常见的。 过量，这些婴儿也会出现高氧血症，这一点值得高度关注，因为研究表明。 实验动物表明，暴露于间歇性缺氧和高氧环境中可以改变正常的 他们对呼吸系统控制的发展并导致呼吸不稳定。 这些低氧血症发作或暴露于高氧血症对成熟的影响程度 极早产儿在 BPD 发展阶段对呼吸系统的控制尚不清楚。 我们提出了一项前瞻性研究，将系统地评估极端早产儿中的这种关联 有 BPD 风险的婴儿。 本研究的主要目的是确定暴露于频繁发作的程度 极度早产儿慢性肺病早期阶段的低氧血症和高氧血症 与呼吸控制系统的成熟和功能改变有关。 极早产儿控制呼吸系统成熟度改变的原因 BPD 很复杂，而且还没有被很好地理解，这阻碍了我们改善这些婴儿护理的能力。 我们的总体目标是参与Pre-Vent合作计划并为更好的 了解导致肺早产儿呼吸和氧合不稳定的因素 通过这种改进的知识，我们期望找到更有效的预防和治疗方法。 针对这一弱势群体的战略。