Oxygenation instability and maturation of control of breathing in evolving BPD.

项目总结 这是迈阿密-米勒大学新生儿科的申请 医学院作为临床研究中心参与早产相关呼吸机的研究 控制(预防)合作计划。这项建议的一部分是一项名为“氧合作用”的前瞻性研究 进展期BPD患者呼吸控制的不稳定和成熟“。 大多数极端早产儿因肺功能改变而出现呼吸衰竭，并伴有 呼吸控制功能不成熟导致的呼吸不稳定。这些婴儿中有相当大一部分 最终导致肺发育异常和支气管肺发育不良(BPD)。早产儿有患心脏病的风险 BPD表现为严重的氧合不稳定，表现为频繁的自发性低氧血症。 在出生后的第一周。因此，这些婴儿接受氧气补充，但这通常是 过量，这些婴儿也暴露在高氧血症中。这是非常令人担忧的，因为在 实验动物已经证明，暴露在间歇性低氧和高氧环境中可以改变正常的 发展他们对呼吸系统的控制，并导致呼吸不稳定。 这些低氧血症或暴露在高氧血症中对胚胎成熟的影响程度 在BPD的发展阶段，极端早产儿的呼吸系统控制尚不清楚。 我们建议进行一项前瞻性研究，系统地评估极端早产儿的这种关联。 婴儿有患BPD的风险。 这项研究的主要目的是确定在多大程度上接触频繁发作的 极早产儿慢性肺部疾病早期低氧血症和高氧血症 与其呼吸控制系统的成熟和功能改变有关。 极早产儿呼吸控制系统成熟改变的原因 BPD是复杂的，而且没有很好的理解，这阻碍了我们改善对这些婴儿的护理的能力。 我们的总体目标是参与预防合作项目，为更好地 早产儿肺部呼吸和氧合不稳定因素的认识 疾病。通过这种改进的知识，我们希望找到更有效的预防和治疗方法 针对这一弱势群体的战略。

PROJECT SUMMARY This is the application from the Division of Neonatology - Department of Pediatrics, University of Miami Miller School of Medicine for participation as a Clinical Research Center in the Prematurity-Related Ventilatory Control (Pre-Vent) cooperative program. Part of this proposal is a prospective study titled “Oxygenation instability and maturation of control of breathing in evolving BPD”. Most extreme premature infants present with respiratory failure due to altered lung function compounded by breathing instability due to an immature respiratory control function. A significant proportion of these infants end up with abnormal lung development and bronchopulmonary dysplasia (BPD). Premature infants at risk for BPD present with significant oxygenation instability in the form of frequent spontaneous episodes of hypoxemia during the first weeks after birth. As a result, these infants receive oxygen supplementation but this is often excessive and these infants are also exposed to hyperoxemia. This is of great concern because studies in experimental animals have shown that exposure to intermittent hypoxia and hyperoxia can alter the normal development of their control of breathing system and contribute to respiratory instability. The extent to which these episodes of hypoxemia or the exposure to hyperoxemia impact on the maturation of the control of breathing system in extreme premature infants during the evolving stages of BPD is unknown. We propose a prospective study that will systematically evaluate such association in extreme premature infants at risk for BPD. The main objective of this study is to determine the extent to which exposure to frequent episodes of hypoxemia and hyperoxemia in extreme premature infants during the early stages of their chronic lung disease is associated with altered maturation and function of their respiratory control system. The causes for the altered maturation of the system that controls breathing in extreme premature infants with BPD are complex and not well understood and this hinders our ability to improve the care of these infants. Our overall goal is to participate in the Pre-Vent cooperative program and contribute to a better understanding of the factors that cause respiratory and oxygenation instability in premature infants with lung disease. Through this improved knowledge we expect to identify more effective preventive and treatment strategies for this vulnerable population.