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: 10011843
• 负责人: EDUARDO H BANCALARI
• 金额: $ 54.29万
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10011843
• 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; 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; neonatal period; 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.

项目摘要 这是迈阿密米勒大学新生儿学系的申请 - 儿科 医学院作为与早产相关的临床研究中心参与 控制（前）合作计划。该提案的一部分是一项名为“氧合的前瞻性研究 不稳定性和控制呼吸的控制不断发展的BPD。 由于肺功能改变而导致的大多数极端早产婴儿，呼吸衰竭。 由于未成熟的呼吸控制功能而引起的呼吸不稳定。这些婴儿中很大一部分 最终以异常的肺发育和支气管肺发育不良（BPD）。过早的婴儿有风险 BPD以低氧血症的常见赞助商发作的形式存在明显的氧合不稳定性 在出生后的头几周。结果，这些婴儿会收到补充氧气，但这通常是 过度，这些婴儿也暴露于高氧血症。这是非常关注的，因为研究 实验动物表明，暴露于间歇性缺氧和高氧可以改变正常 发展他们对呼吸系统的控制并有助于呼吸不稳定。 这些低氧血症或暴露于高氧血症对成熟的影响的程度 在BPD不断发展的阶段，极端早产婴儿中呼吸系统的控制尚不清楚。 我们提出了一项前瞻性研究，该研究将系统地评估这种关联 有BPD风险的婴儿。 这项研究的主要目的是确定经常暴露于多大程度的程度 在其慢性肺部疾病早期的极端早产婴儿中低氧血症和高氧血症 与其呼吸控制系统的成熟和功能改变有关。 控制系统的成熟的原因，该系统控制着呼吸的极端早产儿 BPD很复杂且不太了解，这阻碍了我们改善对这些婴儿的护理的能力。 我们的总体目标是参加货运前合作计划，并为更好的做法做出贡献 了解肺过早婴儿导致呼吸和氧合不稳定性的因素 疾病。通过这种改善的知识，我们希望确定更有效的预防和治疗 这个脆弱人群的策略。