PREDICT NEED FOR RESPIRATORY SUPPORT AND SURFACTANT IN NEWBORNS

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。 更多地使用产前类固醇、表面活性物质和机械通气，改善了早产儿的预后。然而，可能过度使用机械呼吸机可能会导致创伤和慢性肺部疾病。有一些迹象表明，一些早产儿如果在出生时不插管，而是接受鼻腔持续正压通气(CPAP)，可能会有更好的结果。目前，对于哪些婴儿应该在出生时或插管时使用CPAP，还没有达成一致的指导方针。在新生儿呼吸窘迫的治疗过程中，生理学测量，如自发呼气量，可能能够提供指导。这项研究的目的是确定商用便携式肺功能测量设备是否可以用于预测出生后不久对呼吸支持和表面活性物质的需求。这将是一项前瞻性的观察性研究。测量结果不会透露给临床团队，他们将根据自己的判断来决定患者的护理过程。结果将包括呼吸支持程度和表面活性物质治疗。我们计划招募大约100名患者，其中50名出生体重在1500克以下。

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. Increased use of antenatal steroids, surfactant, along with mechanical ventilation, has improved outcomes for premature infants. However, the possible overuse of mechanical ventilators may lead to trauma and chronic lung disease. There is some suggestion that some premature infants may have better outcomes if not intubated at birth, but placed on nasal continuous positive airway pressure (CPAP). At present, there are no consensus guidelines on which infants should be placed on CPAP at birth or intubated. A physiologic measurement, such as spontaneous exhaled volume, may be able to provide guidance in treatment course for newborns with respiratory distress. The aim of this study is to determine if a commercial portable pulmonary function measurement device can be used to predict the need for respiratory support and surfactant soon after birth. This will be a prospective, observational study. The measurements will not be revealed to the clinical team, who will use their judgment in deciding the patient's course of care. Outcomes will include degree of respiratory support and surfactant therapy. We plan to enroll approximately 100 patients, 50 below 1500 grams birth weight.