Patterns of Hypoxia and Mortality in the SUPPORT Trial Cohort

描述(申请人提供)：早产儿补充氧气的使用仍然是一个挑战，因为持续的低氧和高氧，氧气的波动与婴儿发病率有关。在一项大型多中心试验(表面活性物质、正压和氧合随机试验或支持)中，早产儿被随机分配到低氧水平，婴儿死亡率意外增加。此外，参与试验的一组亚队列婴儿的数据显示，低氧饱和度目标组的氧气水平波动或间歇性低氧(IH)事件的发生率更高。因此，虽然婴儿死亡率上升的原因尚不清楚，但间歇性低氧可能起到了关键作用。我们这项建议的目标是量化间歇性缺氧的模式(发生率、持续时间、严重程度和时间)，以及它们与基线血氧饱和度的相互作用，将死亡婴儿与存活婴儿进行比较。来自支持试验的现有连续脉搏血氧饱和度记录将被审查死亡的婴儿，并与支持试验存活的婴儿进行比较。我们小组开发的一种新的计算机程序和技术将用于分析基线血氧饱和度和每天氧波动的发生率和模式，以确定与婴儿死亡相关的氧合变化。及早识别氧气波动的风险模式可能会导致及时干预，以降低这一高危队列中的婴儿死亡率。

DESCRIPTION (provided by applicant): The use of supplemental oxygen in preterm infants continues to be a challenge as sustained low and high oxygen, and fluctuations in oxygen have been implicated in infant morbidity. In a large multi-center trial (Surfactant, Positive Pressure, and Oxygenation Randomized Trial or SUPPORT), preterm infants randomized to a low level of oxygen revealed an unexpected increase in infant mortality. In addition, data in a subcohort of infants enrolled in the trial showed a higher incidence of fluctuations in oxygen levels, or intermittent hypoxia (IH) events, in the low oxygen saturation target group. Therefore, although the cause for the increased infant mortality is unknown, intermittent hypoxia may have played a key role. Our objective for this proposal is to quantify patterns (incidence, duration, severity an timing) of intermittent hypoxia and their interaction with baseline oxygen saturation in infants who died compared to infants who survived. Existing continuous pulse oximetry recordings from the SUPPORT trial will be reviewed for infants who died and compared to SUPPORT trial infants who survived. A novel computer program and techniques developed by our group will be used to analyze both baseline oxygen saturation and the incidence and patterns of oxygen fluctuations on a daily basis to identify variations in oxygenation associated with infant mortalit. Early identification of risk patterns of oxygen fluctuations may lead to timely intervention to reduce infant mortality in this high risk cohort.