Bilirubin Binding Capacity To Assess Bilirubin Load in Preterm Infants

胆红素结合能力评估早产儿胆红素负荷

• 批准号: 9025399
• 负责人: VINOD K BHUTANI
• 金额: $ 21.35万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9025399
• 关键词: Acute; Address; Age; Albumins; Algorithms; Antioxidants; Auditory; Bilirubin; Binding; Biochemical Markers; Biological Assay; Biological Factors; Biological Markers; Buffers; Caring; Clinical; Complex; Data; Development; Developmental Process; Disease; Equilibrium; Exposure to; Family; Gestational Age; Hearing; Hemolysis; Hyperbilirubinemia; Impairment; Infant; Intervention; Knowledge; Lead; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Morbidity - disease rate; Neonatal; Neurodevelopmental Impairment; Neurologic Dysfunctions; Neuropathy; Oxidants; Phototherapy; Premature Infant; Process; Production; Property; Publications; Refractory; Reporting; Research; Risk; Role; Serum Albumin; Small Business Innovation Research Grant; Syndrome; Testing; Time; Transfusion; Translating; Translations; United States National Institutes of Health; base; cohort; early onset; experience; high risk infant; indexing; innovation; mortality; nanotechnique; nervous system disorder; neurotoxicity; oculomotor; phase 2 study; phenotypic biomarker; postnatal; predictive marker; preterm newborn; prevent; public health relevance; total measurement Bilirubin; visual motor; visual process; visual processing

 DESCRIPTION (provided by applicant): Most preterm newborns are managed by ad hoc use phototherapy to reverse hyperbilirubinemia with the intent to prevent bilirubin neurotoxicity. A precise threshold-based relationship between specific total bilirubin levels and intervention has been elusive. This is most likely due to other biomarkers such as hemolysis, developmental maturation, concurrent illnesses, or even interventions, may impede bilirubin/albumin binding. The over- prescription of phototherapy has impacted clinical and family-centered care, and in the extreme preterm infants, it may have augmented their risk of mortality. Thus, the opportunity to precisely individualize phototherapy in order to reduce its prescription is unique. We have assembled a transdisciplinary team to examine critical unanswered questions including the postnatal role of bilirubin binding capacity (BBC) in the context of clinical modifiers and antecedents for a domain of recently reported bilirubin-induced neurologic disorders that includes neuro-anatomical, hearing, visual and developmental processing impairments. In this study, we will evaluate two new innovative nanotechniques to quantify bilirubin load for the first time in the context of a clinical decision algorithm to identify those most at risk for any bilirubn-related neurotoxicity. We anticipate that knowledge gained from this study will lead to ethically testable hypotheses to prescribe phototherapy with precision.

 描述（由申请方提供）：大多数早产新生儿通过特殊的光疗来逆转高胆红素血症，旨在预防胆红素神经毒性。特异性总胆红素水平和干预之间精确的阈值关系一直难以捉摸。这很可能是由于其他生物标志物，如溶血、发育成熟、并发疾病或甚至干预，可能会阻碍胆红素/白蛋白结合。光疗的过度处方已经影响了临床和以家庭为中心的护理，并且在极端早产儿中，它可能增加了他们的死亡风险。因此，精确地个性化光疗以减少其处方的机会是独一无二的。我们已经组建了一个跨学科的团队来研究关键的未回答的问题，包括胆红素结合能力（BBC）在临床修饰剂和前因的背景下，最近报道的胆红素诱导的神经系统疾病，包括神经解剖，听力，视觉和发育处理障碍的域出生后的作用。在这项研究中，我们将评估两种新的创新纳米技术，以在临床决策算法的背景下首次量化胆红素负荷，以确定最有可能发生任何胆红素相关神经毒性的患者。我们预计，从这项研究中获得的知识将导致道德上可检验的假设，以精确地规定光疗。