ESOPHAGEAL MOTILITY AND AIRWAY DEFENSES AMONG INFANTS

描述（由申请人提供）： 新生儿喂养困难和气道相关并发症， 对婴儿死亡率和发病率有很大影响， 社会经济后果，可能与咽部的运动功能有关， 食道或胃，可能依赖于神经控制和肌肉 功能早产、围产期窒息和先天性畸形 代表了三个重要的因素，喂养困难， 不能茁壮成长并长期遭受营养不良的婴儿， 剥夺，胃食管反流，除了慢性肺病和 其他危及生命的事件。我们的长期目标是确定 发育中婴儿喂养失败和气道受损的机制， 为循证诊断和治疗干预铺平道路。具体 目标1将决定 吞咽和气道安全。我们将评估基础和保护运动 涉及吞咽的咽和食管阶段的机制 在健康和疾病期间发育的婴儿。第2章调查 婴儿食管和气道保护或损害的机制 患有先天性前肠畸形和神经系统疾病使用 在我们中心开发的成熟技术，创新的 微压水灌注技术和专门设计的 带套管传感器的微压导管，我们将测量压力 前肠内不同层次的关系。呼吸功能 同时记录测量结果，以建立关系 食管运动和呼吸功能之间的健康和疾病， 以确保受试者的安全。除了重复测量的ANOVA外， 学生t检验，我们将使用增长曲线分析与逻辑模型， 允许使用纵向分组数据。这些研究将建立 随着发育改善基础和保护性食管运动功能，以及 确定婴儿喂养失败和气道安全的机制。

DESCRIPTION (provided by applicant): Feeding difficulties and airway-related complications in neonates, which contribute significantly to the infant mortality and morbidity with enormous socioeconomic consequences, might be related to motor functions of pharynx, esophagus, or stomach which may be dependent upon neural control and muscular function. Prematurity, perinatal asphyxia, and congenital abnormalities represent three important contributory factors to feeding difficulty among infants, who fail to thrive and chronically suffer from nutritional deprivation, gastroesophageal reflux, in addition to chronic lung disease and other life-threatening events. Our long-term objective is to define the mechanisms of feeding failure and airway compromise in developing infants, to pave way for evidence-based diagnosis and therapeutic intervention. Specific Aim 1 will determine maturational changes in the relationship between deglutition and airway safety. We will evaluate the basal and protective motor mechanisms involved in pharyngeal and esophageal phases of swallowing in developing infants during health and disease. Specific Aim 2 will investigate the mechanisms of esophageal and airway protection or compromise in infants with congenital foregut anomalies and neurologic disorders. Using well-established techniques developed at our Center, the innovative micromanometric water perfusion technique and a specially designed micromanometric catheter with sleeve sensor, we will measure pressure relationships at various levels within the foregut. Respiratory function measurements will simultaneously be recorded to to establish the relationship between esophageal motility and respiratory function in health and disease, and to ensure subject safety. In addition to ANOVA for repeated measures and students t-test, we will use growth curve analysis with a logistic model to permit the use of longitudinal grouped data. These studies will establish improved basal and protective esophageal motor function with development, and identify mechanisms of feeding failure and airway safety in infants.