Development of a brain-specific nutritional status indicator for very preterm infants

为极早产儿开发大脑特异性营养状况指标

• 批准号: 10710198
• 负责人: Mandy Brown Belfort
• 金额: $ 68.46万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10710198
• 关键词: Address; Affect; Age; Air; Auditory; Biolectric Impedance; Biometry; Birth; Body Composition; Body measure procedure; Brain; Brain Injuries; Clinical; Cohort Studies; Collaborations; Data; Development; Diet; Dietary Intervention; Dietary intake; Electroencephalography; Epidemiology; Equation; Equipment; Event-Related Potentials; Fatty acid glycerol esters; Foundations; Gestational Age; Goals; Growth; Health; Hospitalization; Impairment; Individual; Infant; Intervention; Knowledge; Length; Malnutrition; Measurement; Measures; Micronutrients; Monitor; Morbidity - disease rate; Neonatal Intensive Care; Neonatal Intensive Care Units; Neonatology; Neurodevelopmental Impairment; Neurosciences; Nutrient; Nutrition Assessment; Nutritional; Nutritional Study; Nutritional Support; Nutritional status; Organ; Outcome; Participant; Performance; Plethysmography; Population; Pregnancy; Premature Infant; Proteins; Publishing; Recovery; Research Infrastructure; Research Personnel; Resources; Rest; Sampling; Site; Specificity; Structure; Techniques; Time; Tissues; Translating; Vulnerable Populations; Weight Gain; Work; behavior measurement; brain health; brain magnetic resonance imaging; brain size; clinical application; clinical care; clinical practice; cohort; critical period; early detection biomarkers; evidence base; extreme prematurity; fetal; improved; improved outcome; innovation; magnetic resonance imaging/electroencephalography; neurodevelopment; nutrition; public health relevance; randomized trial; recruit; respiratory; response; virtual

PROJECT SUMMARY/ABSTRACT Each year, over 63,000 U.S. infants are born very preterm, below 32 weeks of gestation. With >90% now surviving to discharge from the neonatal intensive care unit (NICU), reducing the short- and long-term morbidities has become the highest priority. Neurodevelopmental impairment is a burdensome long-term morbidity that affects 50-60% of very preterm infants after NICU discharge. Nutrition is a cornerstone of clinical care in the NICU and represents a highly modifiable strategy to support healthy brain development during a critical period, thereby reducing long-term impairments. Previous studies have highlighted nutrient accretion into tissues as a key driver of healthier brain development and better neurodevelopmental outcomes. A current gap is in accurate, specific, and feasible strategies to assess and monitor nutrient accretion over time. The overall aim of this study is to investigate fat-free mass accretion as a dynamic bioindicator of nutritional status in the NICU. The specific aims involve establishing a new fetal reference for fat-free mass that covers the entire spectrum of preterm gestational ages, from 23 to 35 weeks, and using this reference to define targets for fat-free mass accretion that are based on neurodevelopmental outcomes. This study applies the innovative concept of “growth quality” to NICU nutrition research. Innovative approaches include the application of bioimpedance analysis to measure body composition in the NICU setting, and the use of quantitative brain magnetic resonance imaging (MRI) and electroencephalography (EEG) as early biomarkers of neurodevelopment in this population, in addition to standard behavioral measures. Our overarching goal is to improve long-term health and developmental outcomes of very preterm infants through pragmatic, evidence- based innovations in nutritional assessment and care during the NICU hospitalization. The results of this study will lay the foundation for fat-free mass-driven dietary interventions in the NICU setting. This study has strong potential to provide an impactful paradigm shift in the approach to the assessment and monitoring of nutritional status and ultimately the leveraging of nutritional strategies during a critical window in development to improve outcomes for this vulnerable population.

项目摘要/摘要 每年，超过63,000名美国婴儿出生的早产，妊娠32周以下。现在> 90％ 从新生儿重症监护室（NICU）生存，减少了短期和长期 病态已成为最高优先事项。神经发育障碍是长期的野生 NICU出院后影响50-60％的非常早产的发病率。营养是临床的基石 NICU的护理，代表了一种高度可修改的策略，以支持健康的大脑发育 关键时期，从而减少了长期障碍。先前的研究突出了营养积聚 进入组织，是更健康的大脑发育和更好的神经发育结果的关键驱动力。电流 随着时间的推移，差距具有准确，具体和可行的策略，可以评估和监测营养积聚。 这项研究的总体目的是研究无脂肪的质量积聚，作为营养状况的动态生物指标 在NICU。具体目的涉及建立新的无脂肪质量参考 从23到35周的早产妊娠年龄的整个范围，并使用此参考来定义目标 基于神经发育结果的无脂肪质量积聚。这项研究应用了创新 NICU Nutrition Research的“增长质量”的概念。创新方法包括应用 生物阻抗分析以测量NICU环境中的身体成分，并使用定量大脑 磁共振成像（MRI）和脑电图（EEG）作为早期生物标志物 除标准行为措施外，该人群中的神经发育。我们的总体目标是 通过务实的证据 - NICU住院期间，基于营养评估和护理的创新。这项研究的结果 将在NICU环境中为无脂肪驱动的饮食干预奠定基础。这项研究有很强的 在评估和监测营养的方法中提供有影响力的范式转变的潜力 地位，最终在开发的关键窗口中利用营养策略来改善 这个脆弱人群的结果。