DEXAMETHASONE STUDY

地塞米松研究

• 批准号: 7724701
• 负责人: CHARLES RICHARD NEAL
• 金额: $ 29.46万
• 依托单位: UNIVERSITY OF HAWAII AT MANOA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7724701
• 关键词: Animal Model; Behavioral; Catheters; Cerebral Palsy; Chronic; Clinic; Clinical; Clinical Research; Collaborations; Computer Retrieval of Information on Scientific Projects Database; Continuous Positive Airway Pressure; Development; Dexamethasone; Dose; Evaluation; Exposure to; Extremely Low Birth Weight Infant; Funding; Glucocorticoids; Grant; Human Milk; Hydrocortisone; Incidence; Infant; Institution; Liquid substance; Manuscripts; Measures; Metabolic acidosis; Movement; Necrotizing Enterocolitis; Neonatal; Nose; Palliative Care; Parents; Participant; Physiological; Post-Traumatic Stress Disorders; Pregnancy; Premature Infant; Principal Investigator; Quality of life; Research; Research Personnel; Resources; Respiratory Failure; Sodium Acetate; Sodium Chloride; Source; United States National Institutes of Health; craniofacial; fetal; health related quality of life; heliox; maternal stress; multidisciplinary; neurodevelopment; prevent; programs; research study

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. During year three of this project I moved my focus away from the animal model that initially drove this proposal to a clinical research focus. Several projects are ongoing, once near completion. Due to the use of shorter courses and lower doses of glucocorticoids in clinical practice, we altered the initial aims of the proposal to study the effects of exposure to a short course of either dexamethasone or hydrocortisone during the early neonatal period on development of the LHPA axis. We have completed analysis of behavioral and physiological studies of our dexamethasone vs. hydrocortisone study and are readying a manuscript for submission. Development of a clinical study to examine effects of chronic maternal stress on neurodevelopment is on hold while the group studying pregnancy and PTSD ready a proposal for submission. As a result I have moved my focus onto development of several clinical research studies. Each of these are in collaboration with the Clinical Research Center, and for each I am the principal investigator. These include 1) development of a multidisciplinary craniofacial clinic paralleling development of a study of health-related quality of life measures in clinic participants and parents, 2) development and implementation of a fetal and neonatal palliative care program with development of quality of life measures in program participants, 3) evaluation of generalized movements in preterm and term infants to study early prediction of cerebral palsy, 4) use of heliox with nasal CPAP in extremely low birth weight infants to prevent respiratory failure, 5) evaluation of implementation of a breast milk only practice (maternal and donor breast milk) on the incidence of necrotizing enterocolitis in a level III NICU and 6) comparison of sodium chloride versus sodium acetate in arterial catheter fluids in extremely premature infants to limit extent of metabolic acidosis.

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 在这个项目的第三年，我把我的注意力从最初推动这一提议的动物模型转移到了临床研究上。有几个项目正在进行中，一旦接近完成。由于在临床实践中使用了较短的疗程和较低剂量的糖皮质激素，我们改变了该提案的最初目的，即研究在新生儿早期使用短程地塞米松或氢化可的松对LHPA轴发育的影响。我们已经完成了地塞米松与氢化可的松的行为和生理研究的分析，并正在准备提交手稿。一项研究慢性母体应激对神经发育影响的临床研究被搁置，而研究怀孕和创伤后应激障碍的小组准备提交一份提案。因此，我将重点放在了几项临床研究的发展上。每一项都是与临床研究中心合作的，每一项我都是首席研究员。这些措施包括1)在临床参与者和父母中发展与健康相关的生活质量测量研究的多学科颅面诊所，2)制定和实施胎儿和新生儿姑息护理计划，同时在计划参与者中发展生活质量测量，3)评估早产儿和足月儿的全身运动，以研究脑性瘫痪的早期预测，4)在极低出生体重的婴儿中使用氦氧结合鼻塞CPAP预防呼吸衰竭，5)评估在III级NICU中实施纯母乳实践(母亲和供者母乳)对坏死性小肠结肠炎发病率的影响；6)比较极早产儿动脉导管液中氯化钠和醋酸钠以限制代谢性酸中毒的程度。