ESOPHAGEAL MOTILITY AND AIRWAY DEFENSES AMONG INFANTS

描述(由申请人提供)： 新生儿喂养困难和与呼吸道相关的并发症 极大地增加了婴儿死亡率和发病率 社会经济后果，可能与咽部运动功能有关， 可能依赖神经控制和肌肉的食道或胃 功能。早产、围产期窒息和先天畸形 代表了导致喂养困难的三个重要因素 不能茁壮成长并长期营养不良的婴儿 剥夺，胃食道反流，以及慢性肺部疾病和 其他危及生命的事件。我们的长期目标是界定 发育中婴儿喂养失败和呼吸道损害的机制 为循证诊断和治疗干预铺平道路。特定的 目标1将决定两国关系的成熟变化 吞咽和呼吸道安全。我们将评估基础马达和保护马达 咽部和食管期吞咽的相关机制 在健康和疾病期间发育的婴儿。《特定目标2》将展开调查 婴幼儿食道和呼吸道保护或损害的机制 有先天性前肠畸形和神经功能障碍。vbl.使用 在我们中心开发的成熟技术，创新的 微压灌水技术和一种特殊设计的 带套筒传感器的微型测压导管，我们将测量压力 前景中不同层次的关系。呼吸功能 测量结果将同时记录到以建立关系 健康和疾病患者的食道动力和呼吸功能之间的关系 以确保受试者的安全。除了重复测量的方差分析和 学生t检验，我们将使用增长曲线分析与Logistic模型 允许使用纵向分组数据。这些研究将确定 随着发育的发展，基础和保护性食道运动功能得到改善，以及 确定婴儿喂养失败和呼吸道安全的机制。

DESCRIPTION (provided by applicant): Feeding difficulties and airway-related complications in neonates, which contribute significantly to the infant mortality and morbidity with enormous socioeconomic consequences, might be related to motor functions of pharynx, esophagus, or stomach which may be dependent upon neural control and muscular function. Prematurity, perinatal asphyxia, and congenital abnormalities represent three important contributory factors to feeding difficulty among infants, who fail to thrive and chronically suffer from nutritional deprivation, gastroesophageal reflux, in addition to chronic lung disease and other life-threatening events. Our long-term objective is to define the mechanisms of feeding failure and airway compromise in developing infants, to pave way for evidence-based diagnosis and therapeutic intervention. Specific Aim 1 will determine maturational changes in the relationship between deglutition and airway safety. We will evaluate the basal and protective motor mechanisms involved in pharyngeal and esophageal phases of swallowing in developing infants during health and disease. Specific Aim 2 will investigate the mechanisms of esophageal and airway protection or compromise in infants with congenital foregut anomalies and neurologic disorders. Using well-established techniques developed at our Center, the innovative micromanometric water perfusion technique and a specially designed micromanometric catheter with sleeve sensor, we will measure pressure relationships at various levels within the foregut. Respiratory function measurements will simultaneously be recorded to to establish the relationship between esophageal motility and respiratory function in health and disease, and to ensure subject safety. In addition to ANOVA for repeated measures and students t-test, we will use growth curve analysis with a logistic model to permit the use of longitudinal grouped data. These studies will establish improved basal and protective esophageal motor function with development, and identify mechanisms of feeding failure and airway safety in infants.