Patient-Oriented Research and Mentoring Program in Prematurity-Associated Pulmonary Morbidity

项目总结 希布斯博士提出了一项以患者为导向的研究和指导计划，重点是 早产儿相关的肺部并发症。她在POR研究方面有很好的记录 以及来自彩虹学院初级教员和实习生的未来导师和可获得性 婴儿和儿童医院(RBC)和CWRU；她将把学员整合到新的 拟议的项目以及其他目前得到资助的地方和多中心研究。 较长期的呼吸道发病率和神经发育迟缓是 早产。在这项拟议的研究中，我们试图描述不成熟之间的联系 呼吸控制，表现为间歇性低氧(IH)，后来表现为呼吸和 一组小于或等于30周早产儿的神经发育发病率 怀孕了。这项建议是对预防案例西部储备进行的为期两年的后续研究 (CWRU)SITE协议，并代表着配对长期临床相关患者的独特机会 结果，由有效问卷衡量，已资助的研究使用 捕捉和分析早期生命的IH事件的复杂技术。我们的假设是IH 出生一周和一个月的发作与复发显著相关 喘息，睡眠呼吸紊乱，神经发育迟缓。在之前的研究中，我们有 证明早产儿的呼吸暂停几乎总是先于饱和度降低，并且 记录了早产儿视网膜病变与IH持续时间之间的新关联 事件和IH事件之间的时间间隔。从这些数据我们推测，它不仅是 更长和更频繁的IH事件，但也有至少一分钟的明显时间间隔 在IH事件之间，这将与长期的临床发病率相关。我们提供 更多的回顾数据表明，IH与喘息障碍有关，以及 在达到登记目标和既往临床有效随访方面都有出色的记录 学习。

PROJECT SUMMARY Dr. Hibbs proposes a patient-oriented research and mentorship program focusing on prematurity-associated pulmonary morbidity. She has a strong track-record for POR research and mentorship and availability of future mentees from junior faculty and trainees at Rainbow Babies and Children's Hospital (RBC) and CWRU; she will integrate mentees in the newly proposed project as well as other currently funded local and multi-center studies. Longer term respiratory morbidity and neurodevelopmental delay are major consequences of preterm birth. In the proposed study, we seek to characterize the association between immature respiratory control, manifesting as intermittent hypoxia (IH), and later respiratory and neurodevelopmental morbidity in a cohort of preterm infants less than or equal to 30 weeks' gestation. This proposal is a two-year follow-up study of the Pre-Vent Case Western Reserve (CWRU) site protocol, and represents a unique opportunity to pair longer-term clinically relevant outcomes, as measured by validated questionnaires, with an already-funded study using sophisticated techniques to capture and analyze early life IH events. Our hypotheses are that IH episodes at one week and one month of life are significantly associated with recurrent wheezing, sleep disordered breathing, and neurodevelopmental delay. In prior studies we have demonstrated that apnea almost always precedes desaturation in preterm infants and have documented a novel association between retinopathy of prematurity, and both the duration of IH events and the time interval between IH events. From these data we speculate that it is not only longer and more frequent IH events, but also distinct time interval of at least one minute between IH events, that will be associated with long-term clinical morbidities. We provide additional retrospective data that IH is associated with wheezing disorders, as well as a remarkable track record for both meeting enrollment goals and effective follow-up in prior clinical studies.