Patterned Experience for Preterm Infants

早产儿的模式化体验

• 批准号: 8234956
• 负责人: Rita H Pickler
• 金额: $ 40.68万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-03 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8234956
• 关键词: Acidosis; Address; Adult; Affect; Age; Apgar Score; Apolipoprotein E; Area; Behavior; Behavioral; Biological Markers; Biology; Birth; Brain; Brain Injuries; Caring; Cerebral Palsy; Characteristics; Clinical; Cognitive; Demographic Factors; Development; Diabetes Mellitus; Disease; Event; Feeding Patterns; Fetal Growth Retardation; Functional disorder; Genetic; Genotype; Goals; Health; Hospitalization; Hour; Hypertension induced by pregnancy; IL8 gene; Impairment; Infant; Infection of amniotic sac and membranes; Interferons; Interleukin-6; Intervention; Knowledge; Language; Learning; Length; Lesion; Life; Measures; National Institute of Nursing Research; Neonatal Intensive Care Units; Neurologic; Neuronal Plasticity; Neurons; Newborn Infant; Oral; Outcome; Pattern; Performance; Perinatal; Pregnancy; Premature Birth; Premature Infant; Premature Rupture Fetal Membranes; Randomized Controlled Trials; Risk; Sepsis; Steroids; Survival Rate; Synapses; Systems Development; TNF gene; Tactile; Testing; Time; Toddler; Touch sensation; Training; Very Low Birth Weight Infant; base; biobehavior; caregiving; cofactor; cognitive function; cost; cytokine; design; disability; experience; feeding; fetal; heart rate variability; improved; in utero; neurobehavioral; neuroprotection; parity; premature; public health relevance; relating to nervous system; skills; social; sucking; therapy design

DESCRIPTION (provided by applicant): The specific aim of this study is to test the effect of a patterned feeding experience (PFE) from birth to discharge from the neonatal intensive care unit (NICU) and beyond for infants born before 30 weeks gestation. The primary aim of this study is to test the effect of a PFE on neurobehavioral organization at three time points; the transition to oral feedings, NICU discharge, and 2 months corrected age (48 weeks PMA). The secondary aims are to test the effects of a PFE on cognitive function at 6 months corrected age, neurobehavioral development; and clinical outcomes. The study's exploratory aim is to describe the potential effects of demographic factors and biobehavioral cofactors on the outcome variables (neurobehavioral organization, cognitive function, neurobehavioral development, and clinical outcomes). It is hypothesized that infants who receive the PFE will have improved neurobehavioral organization, cognitive function, neurobehavioral development, and clinical outcomes in comparison to those who receive usual feeding care. A longitudinal, randomized control trial is proposed with two groups, one receiving a patterned feeding experience from the first gavage feeding through full oral feedings to discharge and one receiving usual feeding care experience. The intervention planned for this project is based on principles of neural plasticity and neuroprotection and is designed to take advantage of neuronal synaptic development and both experience-expectant and experience-dependent characteristics of the developing brain. In addition, the intervention is designed to take advantage of a regularly occurring caregiving and life sustaining event in the life of an infant, feeding. The intervention takes advantage of what we have learned about oral feeding experience in our previous studies, as well as what we have theoretically hypothesized is occurring in relation to the effect of patterned feeding. Thus, the patterned feeding experience intervention designed for this study involves a continuity of tactile experiences associated with feeding to train and build neuronal networks. This intervention provided a critical time in neurologic system development and associated with a recurring event (feeding) should enhance neural connections that may be important for later development, particularly language and other cognitive and neurobehavioral organization skills. The proposed study addresses the National Institute of Nursing Research's focus on the interplay of biology and behavior in an effort to promote health and limit disease. Consistent with NINR's goals, the intervention is based on well-defined underlying mechanisms and includes examination of genetic cofactors and other biomarkers implicated in poor neurobehavioral outcomes. Specifically the proposed study will investigate ways to ameliorate the long-term consequences of prematurity using a unique intervention that will easily adapt to caregiving the NICU.

描述（由申请人提供）：本研究的具体目的是测试从出生到新生儿重症监护室（NICU）及以后出生30周妊娠前婴儿的效果（PFE）（PFE）。这项研究的主要目的是在三个时间点测试PFE对神经行为组织的影响；过渡到口服喂养，NICU出院和2个月校正年龄（48周PMA）。次要的目的是测试PFE在6个月校正年龄，神经行为发育时对认知功能的影响；和临床结果。该研究的探索目的是描述人口统计学因素和生物行为辅助因子对结果变量（神经行为组织，认知功能，神经行为发展和临床结果）的潜在影响。假设接受PFE的婴儿将改善神经行为组织，认知功能，神经行为发展和临床结果，与接受常规喂养护理的人相比。提出了两组纵向，随机对照试验，其中一组通过全面的口服喂养来获得出院的喂食经验，并获得了一项喂食，并获得了一项通常的喂养护理经验。该项目计划的干预措施基于神经可塑性和神经保护的原理，旨在利用发育中的大脑的神经元突触发育以及经验丰富和经验依赖的特征。此外，该干预措施旨在利用婴儿喂养生命中定期发生的护理和维持生命事件。干预措施利用了我们先前研究中对口服喂养经验的了解，以及我们在理论上假设的情况正在与图案喂养的效果有关。因此，为本研究设计的图案喂养经验干预涉及与喂养和建立神经元网络相关的触觉体验的连续性。这种干预措施为神经系统发展提供了关键的时间，并且与重复事件（喂养）相关联，应增强神经联系，这对于以后的发展可能很重要，尤其是语言以及其他认知和神经行为的组织技能。拟议的研究介绍了国家护理研究所对生物学和行为相互作用的关注，以促进健康并限制疾病。与NINR的目标一致，该干预措施基于定义明确的潜在机制，包括检查遗传辅助因子和其他涉及不良神经行为结果的生物标志物。特别是拟议的研究将调查使用独特的干预措施来改善早产的长期后果的方法，该干预措施将很容易适应护理NICU。