Feeding Behaviors & Energy Cost in Infants with CHD

进食行为

• 批准号: 7244159
• 负责人: BARBARA S MEDOFF-COOPER
• 金额: $ 70.1万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-06-01 至 2010-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7244159
• 关键词: behavioral /social science research tag; cardiovascular function; child behavior; clinical research; congenital heart disorder; developmental neurobiology; dysphagia; eating disorders; electrocardiography; human subject; infant human (0-1 year); infant nutrition disorder; neuropsychological tests; newborn human (0-6 weeks); oral behavior; patient oriented research; pediatric nursing; swallowing

DESCRIPTION: (provided by applicant) This proposal requests continued support for a NINR funded study that had been entitled: Nutritive sucking: Physiological and Behavioral correlates. In the present proposal, we (1) deepen our analysis of feeding organization by integrating measures of sucking, swallowing and breathing over the course of full meals and (2) characterize the feeding patterns of another at-risk population - infants with congenital heart disease (CHD), and (3) relate feeding performance and energy expenditure to problems in growth and development over the first year of life in CHD infants. These infants are often difficult to feel, even when their surgery has improved their cardiac function. Indeed, the success of the surgery often unmasks their severe nutritional syndrome, failure to thrive (FTT). To address this important clinical problem, we propose to measure feeding performance and energy expenditures over the first hear of life in 120 infants who have undergone surgery during the first month of life to correct or palliate sever cardiac abnormalities and 60 healthy newborn controls. The specific aims of our proposed study are as follows: 1) to establish which aspects of feeding performance (e.g. suck/swallow/breathe coordination, temporal patterning of sucking with meals, suck pressure generation, adaptation to variation in flow rate) are most subject to disruption in CHD infant after corrective or palliative surgery; 2) to determine infants' pattern of oropharyngeal adaptation to variations in the flow rate through an artificial nipple, and whether flow rate adjustment represents a viable strategy for improving meal size outcomes; and 3) to determine the relative contributions of disrupted feeding organization and (potentially elevated) energy expenditure to unfavorable growth outcomes, i.e. (i) relate disrupted feeding to growth, (ii) relate energy expenditure to growth, and (iii) integrate energetic and feeding-performance characteristics in a predictive model of failure to thrive in infants with CHD. This study addresses what we believe is the central role of feeding organization in the nutritional status of this patient population; as such, it represents an approach toward early identification, based on feeding performance and energetic profiles, of infants most at risk for developing FTT by the age of one. The present work may offer prospects for targeted behavioral interventions involving modification of flow rates and paced feeds.

描述：(由申请人提供)本提案请求继续支持NINR资助的一项研究，该研究的标题是：营养吸吮：生理和行为相关性。在目前的建议中，我们(1)通过在全餐过程中综合吸吮、吞咽和呼吸的措施来深化对喂养组织的分析，(2)描述另一个高危人群-先天性心脏病(CHD)婴儿的喂养模式，以及(3)将喂养性能和能量消耗与CHD婴儿出生后一年的生长发育问题联系起来。这些婴儿往往很难感觉到，即使他们的手术改善了他们的心脏功能。事实上，手术的成功往往揭示了他们严重的营养综合症--无法茁壮成长(FTT)。为了解决这一重要的临床问题，我们建议测量120名出生后第一个月接受手术纠正或缓解严重心脏异常的婴儿和60名健康新生儿的喂养性能和能量消耗。我们拟议的研究的具体目的如下：1)确定先天性心脏病婴儿在接受矫正或姑息手术后，哪些方面的喂养表现(如吸吮/吞咽/呼吸协调、进食时吸吮的时间模式、吸吮压力的产生、对流速变化的适应)最容易受到干扰；2)确定婴儿口咽对通过人工乳头的流速变化的适应模式，以及流速调节是否代表了改善膳食大小结果的可行策略；3)确定喂养组织紊乱和(潜在增加的)能量消耗对不利生长结果的相对贡献，即(I)喂养中断与生长有关，(Ii)能量消耗与生长有关，以及(Iii)将能量和喂养性能特征整合在先天性心脏病婴儿发育不良的预测模型中。这项研究解决了我们认为的喂养组织在这一患者群体的营养状况中的核心作用；因此，它代表了一种基于喂养性能和能量状况，及早识别一岁前最有可能患FTT的婴儿的方法。本工作可能为涉及改变流速和步调饲料的有针对性的行为干预提供前景。