Non-invasive oscillometry to measure lung mechanics, response to treatments, and predict longer-term pulmonary outcomes among preterm infants: a prospective cohort study

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SUMMARY The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Colm Travers, MD, with the mentorship, training, and research experience needed to become an independent clinician scientist and leader in neonatal pulmonary outcomes research. His long-term career goal is to reduce the increasing burden of respiratory morbidity among the 360,000 survivors of preterm birth per year in the US through novel observational and interventional studies and large scale multi-center clinical trials of interventions that reduce lung injury. To achieve these goals and transition to independence, Dr. Travers and his mentors developed a comprehensive research and career development plan that includes mentorship from an exceptional team of scientists with proven track records of mentorship; intensive didactic training including completion of a Master of Science in Public Health in Outcomes Research; and a research plan that is purposefully designed to provide experiential learning in advanced research methods to study pulmonary outcomes among preterm infants. Survivors of preterm birth are at increased risk for wheeze, asthma, and abnormal pulmonary function tests (PFTs) during childhood. Studies of lung function in preterm infants have been limited by the difficulties with completing infant PFTs, restricting the ability to measure illness severity, assess response to treatments, and understand developmental lung health trajectories. Dr. Travers recently completed two prospective cohort studies using an innovative non-invasive oscillometry technique to quantify pulmonary mechanics in spontaneously breathing term and preterm infants. His early work observed that differences in lung mechanics between term and preterm infants can be reproducibly measured and persist until discharge. In the research plan outlined in this K23 proposal, Dr. Travers will expand upon this novel work, and his specific research aims are directly aligned with his training plan as follows: (1) To determine the extent to which differences in lung mechanics between healthy term infants and preterm infants with and without lung disease after birth persist until discharge from hospital or 40 weeks’ postmenstrual age, (2) To quantify changes in lung mechanics among preterm infants receiving medications for lung disease, and (3) To determine the extent to which abnormalities in pulmonary mechanics detected before discharge persist and predict longer-term pulmonary outcomes at 24 months. A non-invasive method to measure lung mechanics and predict longer-term pulmonary outcomes before discharge from hospital can fundamentally change our understanding of the effect of early postnatal lung development on lung function in preterm infants. In addition, a non-invasive bedside device that objectively measures response to treatments would be both a vital research and clinical tool. Building upon the skills and insights acquired through the proposed training and research plan, Dr. Travers will apply for an R01 to determine the effects of early interventions and therapies on lung mechanics and pulmonary health in early childhood.