Pre-Vent Apnea

项目摘要 这个“呼吸暂停前”应用程序汇集了来自密歇根大学的资深研究人员， 亚拉巴马大学伯明翰分校（UAB;临床研究中心），具有新生儿临床和转化研究方面的专业知识 以及马萨诸塞州大学医学院（UMASS;分析核心）， 呼吸控制和生理系统信号处理方面的专业知识。的总体目标 当地项目是使用UAB的200名妊娠<29周的早产儿的前瞻性队列， 前瞻性地界定和验证与抵御或抵御风险有关的解释机制， 在月经后36周（BPD的生理定义）和 使用多参数生理监测和密集数据进行随访（校正年龄为3个月） 在三个不同的时间范围收集（各96小时）：出生后2周龄、月经后32周 年龄（PMA），36周PMA，以及连续心率、呼吸率和脉搏血氧饱和度 从出生后不久入组到出院的波形记录。 我们将通过以下具体目标实现这一目标： 具体目标1-开发和验证个性化解释模式的数学模型 基于多参数生命体征监测和信号分析方法，以（a）预测低氧血症和/或 在个别婴儿的心动过缓发作发生之前，（B）识别心动过缓异常的模式 与BPD伴或不伴肺动脉高压，以及伴或不伴呼吸或 3个月矫正龄时的喂养支持。 具体目标2 -确定晚期（出生后14天或之后）轻度允许性高碳酸血症是否相关 呼吸暂停、心动过缓和低氧血症发作减少，氧合稳定性提高。 具体目标3 -确定伺服控制的氧气环境是否与减少 与经鼻给氧相比， 插管。 此外，对于多中心合作项目，我们将与其他临床研究合作 中心和领导和数据协调中心（LDCC）的多中心协议，将 研究急性和慢性氧合不稳定结局的解释性控制机制 发病率 我们参与该项目的最终目标是更深入地了解 呼吸系统疾病，并发现新的预防和治疗目标 在生命之初改善非常脆弱儿童的成果的战略。

Project Summary This “Pre-Vent Apnea” application brings together established investigators at the University of Alabama at Birmingham (UAB; Clinical Site) with expertise in neonatal clinical and translational research and at the University of Massachusetts Medical School (UMASS; Analytical Core) with complementary expertise in control of breathing and signal processing in physiological systems. The overall objective of the local project is to use a prospective cohort of 200 preterm infants <29 weeks gestation at UAB to prospectively define and validate ventilatory mechanisms associated with resilience against or risk for development of impaired oxygenation at 36 weeks' postmenstrual age (physiologic definition of BPD) and at follow-up (corrected age of 3 months) using multiparametric physiologic monitoring and intensive data collection (96 hours each) at three distinct time frames: 2 weeks postnatal age, 32 weeks post-menstrual age (PMA), 36 weeks PMA, in addition to continuous heart rate, respiratory rate, and pulse oximetry waveform recording from enrollment soon after birth until discharge. We will address the objective by the following Specific Aims: Specific Aim 1- Development and validation of mathematical models of personalized ventilatory patterns based on multiparametric vital signs monitoring and signal analysis methods to (a) predict hypoxemic and/or bradycardic episodes in individual infants before they occur, (b) identify patterns of ventilatory abnormalities associated with BPD with and without pulmonary hypertension, as well as with and without respiratory or feeding support at 3 months corrected age. Specific Aim 2 - Determine if late (at or beyond postnatal day 14) mild permissive hypercapnia is associated with reduction in apnea, bradycardia, and hypoxemic episodes and with improved stability of oxygenation. Specific Aim 3 – Determine if servo-controlled oxygen environment is associated with reduction in hypoxemic episodes and improved stability of oxygenation, as compared to oxygen administered by nasal cannula. In addition, for the multicenter collaborative project, we will collaborate with other clinical research centers and a Leadership and Data Coordinating Center (LDCC) on a multicenter protocol that will investigate ventilatory control mechanisms in outcomes of instability of oxygenation and acute and chronic morbidity. The ultimate goal of our participation in this project is to gain greater insight into the pathogenesis of respiratory disorders in extremely preterm infants and discover targets for new prevention and treatment strategies to improve outcomes for very vulnerable children at the beginning of life.