Patterns of Hypoxia and Mortality in the SUPPORT Trial Cohort

支持试验队列中的缺氧和死亡率模式

• 批准号: 8759060
• 负责人: RICHARD JOHN MARTIN
• 金额: $ 7.93万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8759060
• 关键词: Address; Area Under Curve; Cardiovascular system; Cessation of life; Clinical; Data; Descriptor; Early identification; Enrollment; Event; Exposure to; Future; Hyperoxia; Hypoxia; Incidence; Infant; Infant Mortality; Intention; Intervention; Lead; Life; Measurement; Modeling; Morbidity - disease rate; Neonatal Mortality; Oxidative Stress; Oxygen; Pattern; Play; Population; Premature Infant; Pulse Oximetry; Randomized; Regulation; Retinopathy of Prematurity; Risk; Rodent Model; Role; Severities; Stratification; Supplementation; Survivors; Techniques; Therapeutic; Time; Variant; Visual impairment; base; biological adaptation to stress; cohort; computer program; design; high risk; improved; infant death; infant morbidity; insight; mortality; neonate; novel; postnatal; pressure; public health relevance; randomized trial; respiratory; surfactant; time interval

DESCRIPTION (provided by applicant): The use of supplemental oxygen in preterm infants continues to be a challenge as sustained low and high oxygen, and fluctuations in oxygen have been implicated in infant morbidity. In a large multi-center trial (Surfactant, Positive Pressure, and Oxygenation Randomized Trial or SUPPORT), preterm infants randomized to a low level of oxygen revealed an unexpected increase in infant mortality. In addition, data in a subcohort of infants enrolled in the trial showed a higher incidence of fluctuations in oxygen levels, or intermittent hypoxia (IH) events, in the low oxygen saturation target group. Therefore, although the cause for the increased infant mortality is unknown, intermittent hypoxia may have played a key role. Our objective for this proposal is to quantify patterns (incidence, duration, severity an timing) of intermittent hypoxia and their interaction with baseline oxygen saturation in infants who died compared to infants who survived. Existing continuous pulse oximetry recordings from the SUPPORT trial will be reviewed for infants who died and compared to SUPPORT trial infants who survived. A novel computer program and techniques developed by our group will be used to analyze both baseline oxygen saturation and the incidence and patterns of oxygen fluctuations on a daily basis to identify variations in oxygenation associated with infant mortalit. Early identification of risk patterns of oxygen fluctuations may lead to timely intervention to reduce infant mortality in this high risk cohort.

描述（由申请人提供）：在早产儿中使用辅助供氧仍然是一个挑战，因为持续的低氧和高氧，以及氧的波动与婴儿发病率有关。在一项大型多中心试验（表面活性剂、正压和氧合随机试验或SUPPORT）中，早产儿被随机分配到低氧水平，婴儿死亡率意外增加。此外，试验中入组的婴儿子队列的数据显示，低氧饱和度目标组中氧水平波动或间歇性缺氧（IH）事件的发生率较高。因此，虽然婴儿死亡率增加的原因尚不清楚，但间歇性缺氧可能起了关键作用。我们的目标是量化模式（发病率，持续时间，严重程度和时间）的间歇性缺氧和他们的相互作用与基线血氧饱和度的婴儿谁死了相比，婴儿谁活了。将对死亡婴儿的SUPPORT试验的现有连续脉搏血氧饱和度记录进行审查，并与存活的SUPPORT试验婴儿进行比较。我们小组开发的一种新的计算机程序和技术将用于分析基线血氧饱和度和每日血氧波动的发生率和模式，以确定与婴儿死亡率相关的氧合变化。早期识别氧气波动的风险模式可能会导致及时干预，以降低这一高风险队列中的婴儿死亡率。