THE SURFACTANT POSITIVE AIRWAY PRESSURE AND PULSE OXIMETRY TRIAL

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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. This research asks two basic questions: which of two lung treatments in premature babies is better for the baby?s lungs; and what is the appropriate level of oxygen in premature infants blood. The two lung treatments are 'CPAP' (positive air pressure to help keep the lungs inflated) and 'intubation,' placement of a breathing tube in the infant?s airway with administration of surfactant through this breathing tube. Regardless of which treatment is used, all babies who need help with breathing are at risk of developing a type of chronic lung disease called 'Bronchopulmonary Dysplasia,' or 'BPD'. Since 1990, surfactant has been available to help premature babies breathe easier, but they must be intubated to give this medicine. Oxygen is also given whenever a baby is not able to get enough oxygen into his/her blood by breathing room air. It is important not to give too much oxygen because too much oxygen may cause an eye disease called 'Retinopathy of Prematurity,' or 'ROP,' that may result in poor vision or even blindness. In this study, infants who receive CPAP and who have specific guidelines for intubation will be compared to infants who are intubated and are given surfactant soon after birth. The study also compares a lower range (85-89%) and higher range (91-95%) of oxygen levels in the blood. It is known that higher oxygen ranges are associated with eye disease, however, the safest oxygen range is still unknown. We hope to find out if a lower range results in less ROP.