AR CAREER DEVELOPMENT COBRE: PREVENTING THE LONG-TERM NEONATAL PAIN

AR 职业发展 COBRE：预防长期新生儿疼痛

• 批准号: 8168241
• 负责人: WHIT HALL
• 金额: $ 14.54万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8168241
• 关键词: Adult; Adverse effects; Animal Model; Behavioral; Caring; Clinic; Clinical; Colon; Computer Retrieval of Information on Scientific Projects Database; Data; Development; Effectiveness; Functional disorder; Funding; Grant; Healthcare; Hormonal; Human; Hypersensitivity; Individual; Inflammation; Injury; Institution; Intervention; Kangaroo-Mother Care; Laboratories; Life; Long-Term Effects; Measures; Medicine; Neonatal; Neonatal Intensive Care Units; Outcome; Pacifiers; Pain; Pain management; Physiological; Premature Infant; Procedures; Rattus; Reaction; Refractory; Research; Research Personnel; Resources; Scientist; Skin; Source; Stress; Techniques; Testing; Time; Training; Trauma; United States National Institutes of Health; Visceral; adverse outcome; biological adaptation to stress; career development; design; irritation; neonate; prevent; sugar

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The effects of neonatal pain may result in physiological, hormonal and behavioral reactions that persist into adulthood and may cause functional disorders that are refractory to conventional medicine. Treatments to decrease the effects of neonatal pain have not been adequately researched and existing ones are used capriciously. Therefore, effective pain management and pre-emptive interventions with low side effect profiles are needed. These pre-emptive techniques include skin-to-skin contact with the neonate (kangaroo care), facilitated tucking and suckling sugar-coated pacifiers. In this application, we propose to evaluate the effectiveness and mechanism of action of pre-emptive care to prevent long-term consequences of neonatal pain. The hypothesis is that pre-emptive neonatal interventions that will decrease stress responses associated with painful neonatal procedures will also decrease adverse consequences later in life. To test this hypothesis, we first propose to examine whether neonatal cuddling (NC) around the time of injury can prevent the long-term effect of neonatal colon inflammation/pain in the adult rat. Second, we will show that neonatal cuddling (kangaroo care) will positively impact the health care outcomes of babies in the neonatal intensive care unit (NICU). The ability of these pre-emptive measures to reduce the long-term consequences in adults who were exposed to painful/stressful neonatal procedures has not been studied in either humans or animal models. To test the central hypothesis, three specific aims were designed. In specific aim 1, behavioral studies will be conducted to show that NC prevents the development of long-term visceral hypersensitivity in the adult rat with neonatal colon irritation, by reducing the stress associated with neonatal injury. In specific aim 2, stress-reduction techniques such as kangaroo care will be tested in the NICU to evaluate their benefits to premature infants who are in stable condition. The long-term consequences of neonatal trauma have been shown repeatedly to be detrimental to the individual in a number of clinical and basic studies. These studies have emphasized the immediate need to develop new preemptive care approaches in the clinical setting to lessen the impact of neonatal trauma. This proposal brings together a team of basic and clinical scientists, both established and in training, to evaluate the impact of stress-reduction techniques on the consequences of neonatal trauma. The studies proposed focus on one central hypothesis that will be tested in the laboratory and the clinic and highlight the high level of synergy among the investigators. If successful, these studies will enable us to generate additional data sufficient to broaden the scope of this proposal and to develop a multi-investigator R01 application. Furthermore, the results should have a positive impact on neonatal care and decrease long-term consequences in adults who were exposed to neonatal pain and stress.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 新生儿疼痛的作用可能导致生理，荷尔蒙和行为反应持续到成年，并可能引起对常规医学难治性的功能障碍。 减少新生儿疼痛作用的治疗方法尚未得到充分研究，现有的治疗方法被反复地使用。 因此，需要有效的疼痛管理和先发制人的干预措施，具有低副作用概况。 这些先发制人的技术包括与新生儿（Kangaroo Care）的皮肤接触，促进和哺乳糖衣的奶嘴。 在本应用中，我们建议评估先发制体护理的有效性和作用机理，以防止新生儿疼痛的长期后果。 假设是，将减少与痛苦的新生儿程序相关的压力反应的预先避免的新生儿干预措施也将减少以后生活中的不良后果。 为了检验这一假设，我们首先建议检查新生儿拥抱（NC）是否在受伤期间是否可以防止新生儿结肠炎症/疼痛对成年大鼠的长期作用。 其次，我们将证明新生儿拥抱（袋鼠护理）将对新生儿重症监护病房（NICU）婴儿的医疗保健结果产生积极影响。在人类或动物模型中尚未研究这些先发制人措施减少暴露于痛苦/压力新生程序的成年人长期后果的能力。 为了检验中心假设，设计了三个特定目标。 在特定的目标1中，将进行行为研究，以表明NC通过减少与新生儿损伤相关的压力来防止成年大鼠患者大鼠长期内脏超敏反应的发展。 在特定的目标2中，将在NICU中测试减少压力的技术，例如袋鼠护理，以评估其对状况稳定的早产儿的益处。 在许多临床和基础研究中，已反复证明新生儿创伤的长期后果对个人有害。 这些研究强调了在临床环境中开发新的先发制人护理方法的迫切需要，以减轻新生儿创伤的影响。 该提案汇集了一个基本和临床科学家的团队，包括建立和培训，以评估减少压力技术对新生儿创伤后果的影响。 研究提出，旨在在实验室和诊所进行测试的一个中心假设，并强调研究人员之间的高水平协同作用。如果成功的话，这些研究将使我们能够生成足够的数据以扩大该提案范围并开发多入侵者R01应用程序。此外，结果应对新生儿护理产生积极影响，并减少暴露于新生儿疼痛和压力的成年人的长期后果。