Pathophysiology of Aerodigestive Reflexes in Infants

婴儿呼吸消化反射的病理生理学

基本信息

批准号：
7772021
负责人：
Sudarshan R Jadcherla
金额：
$ 0.14万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-05-01 至 2011-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7772021
关键词：
Acids Age Air Animals Apple Asphyxia Neonatorum Basic Science Brain Stem Breathing Catheters Cessation of life Characteristics Clinical Coupled Data Defect Defense Mechanisms Development Diagnosis Disease Dose Economic Burden Elements Ensure Enteral Esophageal Event Foundations Frequencies Functional disorder Future Gastroesophageal reflux disease Goals Growth Health Hospitalization Human Hyporeflexia Infant Infant Care Infant Mortality Infusion procedures Intensive Care Units Investigation Juice Length of Stay Life Logistic Regressions Manometry Measurement Mediating Methods Morbidity - disease rate Motor Motor Pathways Muscle Neurologic Output Perinatal Perinatal Care Peristalsis Physicians Physiology Polysomnography Premature Infant Prevalence Primitive foregut structure Recurrence Reflex action Reflux Research Personnel Response Latencies Response to stimulus physiology Risk Safety Sensory Sleep Solid Statistical Models Stimulus Students Survivors System Techniques Testing Therapeutic Time Ultrasonography United States Upper Esophageal Sphincter Water Work abnormal reflex awake base cell motility clinical care clinically relevant critical period evidence base feeding glottis improved innovation neonate nervous system disorder neuromuscular new therapeutic target novel postnatal premature programs relating to nervous system respiratory response skills stem

项目摘要

DESCRIPTION (provided by applicant): Independent feeding and breathing skills are the two important functions for survival in human infants. Feeding difficulties coupled with airway-related complications in infants contribute significantly to infant mortality and morbidity. Lack of a proper understanding of the physiology and pathophysiology of reflexes protective against aspiration during health or disease in developing infants is a fundamental problem that challenges management strategies. Our long-term goal is to develop evidence-based safe feeding strategies in infants at-risk. The current objective is to define the normal development as a basis for understanding abnormality of the sensory-motor neural and muscular control of foregut motility and aerodigestive tract defense mechanisms in human infants. There is a critical need for safety-ensured mechanistic studies that will provide a solid foundation for the management of feeding and airway safety in (1) healthy premature infants and in conditions such as (2) GERD and (3) neurological disease. In aim 1, peristaltic reflexes induced by esophageal stimulation in preterm healthy infants in sleep and awake states are investigated. In aim 2, the relationship of GERD on reflux clearance- and glottal closure- reflexes and comparison with healthy controls are investigated. In aim 3, the effects of neurological malfunction on aerodigestive protective mechanisms and comparison with healthy controls are investigated. Using safety packed, cutting-edge techniques and micromanometry system and novel pharyngo-esophageal manometry catheters, synchronized and integrated respiratory measurements, we will evaluate the sensory and motor elements of the peristaltic reflexes in premature infants, GERD, and neurological illness. In addition, we will evaluate airway protective reflexes with concurrent ultrasound. ANOVA, multiple logistic regression and student's t- test will be used. The new information will create a context for understanding sensory-motor-pathways involved with peristaltic reflexes and airway safety; thus providing a basis for future clinical care or trials.

描述（由申请人提供）：独立喂养和呼吸技能是人类婴儿生存的两项重要功能。婴儿喂养困难加上气道相关并发症会显着增加婴儿死亡率和发病率。对发育中婴儿在健康或疾病期间防止误吸的反射的生理学和病理生理学缺乏正确的理解是挑战管理策略的一个基本问题。我们的长期目标是为高危婴儿制定基于证据的安全喂养策略。当前的目标是定义正常发育，作为理解人类婴儿前肠运动的感觉运动神经和肌肉控制以及呼吸消化道防御机制异常的基础。迫切需要确保安全的机制研究，这将为 (1) 健康早产儿以及 (2) 胃食管反流病 (GERD) 和 (3) 神经系统疾病等情况下的喂养和气道安全管理提供坚实的基础。在目标 1 中，研究了早产健康婴儿在睡眠和清醒状态下食管刺激引起的蠕动反射。在目标 2 中，研究了 GERD 与反流清除和声门闭合反射的关系以及与健康对照的比较。在目标 3 中，研究了神经功能障碍对呼吸消化保护机制的影响以及与健康对照的比较。使用安全包装的尖端技术和微测压系统以及新型咽食管测压导管、同步和集成呼吸测量，我们将评估早产儿、胃食管反流病和神经系统疾病的蠕动反射的感觉和运动要素。此外，我们将通过同步超声评估气道保护反射。将使用方差分析、多重逻辑回归和学生 t 检验。新信息将为理解与蠕动反射和气道安全有关的感觉运动通路创造一个背景；从而为未来的临床护理或试验提供基础。