THE SURFACTANT POSITIVE AIRWAY PRESSURE AND PULSE OXIMETRY TRIAL

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。 这项研究着眼于两个基本问题：对早产儿使用的两种肺部疗法中，哪一种对婴儿的肺部更好；早产儿的血液中合适的含氧量是多少。这两种肺部治疗方法分别是CPAP[帮助保持肺部充气的正压]和插管，这涉及在婴儿体内放置呼吸管？S早期通过这个呼吸管给药一种名为表面活性物质的药物。 研究表明，无论使用哪种治疗方法，所有需要呼吸帮助的婴儿都有患上一种慢性或长期肺部疾病的风险，这种疾病被称为支气管肺发育不良症，简称BPD。自1990年以来，一种名为表面活性物质的药物已经可以帮助早产儿呼吸更轻松，但必须在呼吸道中放置一根管子才能给这种药物。 当婴儿无法通过呼吸室内空气将足够的氧气输送到血液中时，也会使用氧气。医生们知道，确保婴儿获得足够的氧气是很重要的，但不能太多。过多氧气的一个可能的并发症是一种称为早产儿视网膜病变的眼病。或者？ROP，？这可能会导致视力不佳甚至失明。 所有这些治疗方法都经过了仔细的研究，都用于新生儿重症监护室。这是第一项对所有这些方法的使用进行仔细比较的研究，这些方法从婴儿出生后的第一个时刻开始，一直跟踪到婴儿出生后至少18个月，如果他们不是早产儿的话。 在这项研究中，接受产房CPAP并有放置呼吸管的具体指南的婴儿将与在产房或出生后不久放置呼吸管和给予表面活性物质的婴儿进行比较。这项研究还将比较保持较低范围[85%-89%]或较高范围[91%-95%]的血氧水平[饱和度]。虽然众所周知，较高的氧气范围与更多的眼病有关，但最安全的氧气范围仍然未知。我们希望找出较低的范围是否会导致较低的ROP[早产儿视网膜病变]。

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 is looking at two basic questions: which of two lung treatments used with premature babies is better for the babys lungs; and what is the appropriate level of oxygen in the blood in premature infants. The two lung treatments are CPAP [positive air pressure to help keep the lungs inflated] and intubation, which involves placement of a breathing tube in the infant?s airway with early administration of a medication called surfactant through this breathing tube. Research has shown, regardless of which treatment is used, that all babies who need help with breathing are at risk of developing a type of chronic, or long lasting, lung disease called Bronchopulmonary Dysplasia, or BPD for short. Since 1990 a medication, called surfactant has been available to help premature babies breathe easier, but a tube must be placed in the airway to give this medicine. Oxygen is also used whenever a baby is not able to get enough oxygen into his/her blood by breathing room air. Doctors know that it is important to be sure a baby is getting enough, but not too much oxygen. One possible complication of too much oxygen is an eye disease called ?Retinopathy of Prematurity,? or ?ROP,? that may result in poor vision or even blindness. All of these treatments have been carefully studied and all are used in Newborn ICUs. This is the first study to carefully compare the use of all of these methods starting from the first moments after birth and following the babies until at least 18 months after they would have been born, if they had not been premature. In this study, infants who receive delivery room CPAP and who have specific guidelines for having a breathing tube placed will be compared to infants who have a breathing tube placed and surfactant given in the delivery room or very soon after birth. The study will also compare keeping a lower range [85-89%] or a higher range [91-95%] of oxygen levels in the blood [saturation]. While it is known that higher oxygen ranges are associated with more eye disease, the safest oxygen range is still unknown. We hope to find out if a lower range results in less ROP [Retinopathy of Prematurity].