Hibbs -Association Between Intermittent Hypoxia and Later Respiratory Morbidity

项目摘要 较长期的呼吸道发病率仍然是早产的主要后果。我们寻求 描述未成熟的呼吸控制表现为间歇性之间的联系 一组小于或等于30岁的早产儿的缺氧[IH]和后来的呼吸道发病率 几周的孕期。我们在目标1和目标2中的假设是IH发作在一周和一周 生命月份与住院时间延长和 呼吸支持，以及调整后六个月的喘息障碍高发率 年龄。在目标3中，我们假设低5-羟色胺水平与高发病率有关。 在开始脱饱和后，呼吸努力恢复的时间延长。最后，在目标4中，我们 假设高血压发作与氧化应激标志物之间的时间关系 由尿液和血液样本确定。在先前的研究中，我们已经证明了呼吸暂停 几乎总是在早产儿减饱和之前，并记录了一种新的 早产儿视网膜病变与IH事件持续时间和时间的关系 IH事件之间的间隔。从这些数据我们推测，它既是较长的IH事件，也是一个 将与以下项目相关联的IH事件之间至少一分钟的不同时间间隔 呼吸道发病率和伴随的氧化应激。这项建议提供了一个独特的 有机会首次量化IH与氧化生物标记物之间的关系。 我们提供了更多的回顾数据，表明IH与两个增加的逗留时间相关 以及出生后喘息障碍，以及在这两次会议上的显著记录 在先前的临床试验中的登记目标和有效随访。另外，我们有一个很强的 利用生物工程收集连续心肺波形的跟踪记录 非常适合多中心数据的信号采集和处理专业知识 收集。总而言之，我们的调查人员在测量和分析 呼吸和饱和波形，IH事件的特征，基础科学 呼吸控制，以及临床呼吸结果的测量，使我们成为理想的 准备执行这一单中心和多站点提案。

Project Summary Longer term respiratory morbidity remains a major consequence of preterm birth. We seek to characterize the association between immature respiratory control manifest as intermittent hypoxia [IH] and later respiratory morbidity in a cohort of preterm infants less than or equal to 30 weeks' gestation. Our hypotheses in Aims 1 and 2 are that IH episodes at one week and one month of life are significantly associated with prolonged duration of hospitalization and respiratory support, as well as a high incidence of wheezing disorders by six months adjusted age. In Aim 3 we hypothesize that low serotonin levels are associated with a high incidence of IH and a prolonged recovery of respiratory effort after onset of desaturation. Finally, in Aim 4 we hypothesize a temporal relationship between IH episodes and markers of oxidative stress determined by urine and blood samples. 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 both longer IH events and a distinct time interval of at least one minute between IH events that will be associated with respiratory morbidity and accompanying oxidative stress. This proposal provides a unique opportunity to quantify, for the first time, a relationship between IH and biomarkers of oxidation. We provide additional retrospective data that IH is associated with both increased length of stay and postnatal wheezing disorders, as well as a remarkable track record for both meeting enrollment goals and effective follow-up in prior clinical trials. Additionally, we have a strong track record for collection of continuous cardiorespiratory waveforms with bioengineering expertise in signal acquisition and processing that is ideally suited for multicenter data collection. In conclusion, our investigators' expertise in the measurement and analysis of respiratory and saturation waveforms, characterization of IH events, the basic science of respiratory control, and the measurement of clinical respiratory outcomes, makes us ideally poised to execute this single center, as well as multisite, proposal.