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

项目摘要 博士希布斯提出了一个以病人为导向的研究和指导计划，重点是 早产相关的肺部疾病。她在POR研究方面有很好的记录 和指导以及彩虹初级教师和学员未来学员的可用性 婴儿和儿童医院（RBC）和CWRU;她将在新的 建议的项目以及其他目前资助的地方和多中心研究。 长期的呼吸系统疾病和神经发育迟缓是 早产在拟议的研究中，我们试图描述不成熟与 呼吸控制，表现为间歇性缺氧（IH），随后出现呼吸和 小于或等于30周早产儿队列的神经发育发病率 怀孕这项建议是一项为期两年的后续研究的前通风案例西储 （CWRU）研究中心方案，并代表了一个独特的机会，配对长期临床相关 结果，通过验证问卷测量，与一个已经资助的研究，使用 捕捉和分析早期IH事件的复杂技术。我们的假设是， 一周和一个月的发作与复发性 哮喘、睡眠呼吸障碍和神经发育迟缓。在之前的研究中， 研究表明，早产儿呼吸暂停几乎总是在去饱和之前， 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。从这些数据中我们推测， 更长和更频繁的IH事件，但至少1分钟的明显时间间隔 IH事件之间，这将与长期临床发病率相关。我们提供 额外的回顾性数据表明IH与喘息性疾病相关， 在达到入组目标和有效随访之前的临床研究中， 问题研究

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.