Inter-hospital Variations In Outcomes Of Very Preterm Infants Admitted To Neonatal Intensive Care Units
Funder
National Health and Medical Research Council
Funding Amount
$130,440.00
Summary
Most babies who are born very preterm (less than 32 weeks' gestation; ie more than 2 months early) are admitted to a neonatal intensive care unit (NICU). These babies stay in hospital for 2 to 4 months and need lots of care (using vast amounts of the available health resources). When compared to babies born at term, these very preterm babies are much more likely to die or to suffer from a range of poor outcomes that impact on their long-term development and quality of life. The Australian and Ne ....Most babies who are born very preterm (less than 32 weeks' gestation; ie more than 2 months early) are admitted to a neonatal intensive care unit (NICU). These babies stay in hospital for 2 to 4 months and need lots of care (using vast amounts of the available health resources). When compared to babies born at term, these very preterm babies are much more likely to die or to suffer from a range of poor outcomes that impact on their long-term development and quality of life. The Australian and New Zealand Neonatal Network (ANZNN) is a collaboration of clinical staff in all 29 NICUs in the region, whose aim is to improve the care of high-risk newborn infants and their families in Australia and New Zealand through collaborative audit and research. This audit has reported considerable differences in the rates of death and poor outcomes between NICUs. Other networks have reported similar variations. Variations in outcomes could be due to 1) differences in the way the diagnosis is made in each unit, 2) differences in how small or ill the babies are when admitted, or 3) different quality of care in each NICU. We need to take account of the first two possibilities before we can compare NICUs fairly and allow them to work towards achieving the best outcomes for very premature babies. To do this, our project will use advanced statistical techniques to look at the risk factors associated with death and poor outcome in very preterm babies. We will then be able to 'predict' outcomes and see if the differences between NICUs are real or not. If the variation between units is explained by differences in clinical practices, then this has enormous potential for quality improvement within the NICUs and through the development of new policy guidelines for clinical practice. The statistical models developed during this project will be useful for clinicians in other health areas and in other countries.Read moreRead less
Generating And Applying Clinical Research To Improve The Outcomes Of Neonatal Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$568,892.00
Summary
Birth is a complex process and sometimes babies require help to make the transition to independent life. Professor Peter Davis is conducting research into how best to support this transition. This involves helping the lungs to work efficiently and supporting the changes in circulation of the blood to the brain and to the rest of the body. His work aims to quickly identify babies who need help and then provide better treatments to make sure they have the best chance of a healthy life.
Sensory Exposure Of Neonates In Single-room Environments (SENSE)
Funder
National Health and Medical Research Council
Funding Amount
$108,902.00
Summary
Preterm babies are often slower to reach developmental milestones than term babies. Extremely preterm babies spend a long time developing in the neonatal unit, which is suboptimal to the womb. Evidence suggests that open neonatal units are bright and loud and single rooms may be better for neonatal development. However, a recent study found poorer neurodevelopment with single rooms. This study aims to improve outcomes in single rooms through the application of a sound and language intervention.
Optimising Early Respiratory Support For Preterm Infants: The HIPSTER Trial
Funder
National Health and Medical Research Council
Funding Amount
$696,791.00
Summary
Premature babies who need breathing support are often given ‘nasal continuous positive airway pressure’ (NCPAP) via large nasal prongs. It works well but is uncomfortable. A newer, popular support is ‘high flow’ (HF) which uses smaller nose prongs and may be more comfortable, but HF has not been well studied. The HIPSTER trial will compare these systems in 750 premature babies, at random half will have NCPAP, half will have HF. We will assess whether babies do equally well with each system.
A Study Of The Impact Of Treating Electrographic Seizures In Term Or Near-term Infants With Neonatal Encephalopathy
Funder
National Health and Medical Research Council
Funding Amount
$1,365,184.00
Summary
Seizures in the newborn infant are common and may be harmful to the developing brain. They are not always recognised. This study investigates whether or not treating all seizures detected using a bedside brain activity monitor improves developmental outcome, compared to just treating seizures that doctors recognise.
Right From The Start: Improving Respiratory Support For Preterm Infants From Their First Breath To Independent Breathing
Funder
National Health and Medical Research Council
Funding Amount
$266,623.00
Summary
My research program with the world leading research team at the Royal Women’s Hospital, Melbourne aims to improve the journey of preterm babies from birth, through the neonatal nursery, to a healthy start at home. Too many preterm babies die or have long term health problems. I will study gentler methods to support breathing from birth, investigate better ways of supporting them until they can breathe independently, and assess how to support more babies to stay in their birth hospitals.
The Impact Of The Life Trajectory Of Extremely Low Gestational Age Neonates On Moral Distress Of Healthcare Professionals Within Neonatal Intensive Care Units
Funder
National Health and Medical Research Council
Funding Amount
$46,622.00
Summary
The provision of care to the smallest and least mature babies (known as Extremely Low Gestational Age Neonates) within neonatal intensive care units (NICUs) is recognised as a frequent source of distress to family and healthcare professionals alike. This study aims to explore how illness severity of preterm babies and predictions of the babies’ long-term outcomes impacts moral distress of doctors and nurses within NICUs. The results of this study will guide interventions to reduce its presence.
The Neonav ECG Tip Location System: Better & Safer Care For Paediatric Intensive Care Patients
Funder
National Health and Medical Research Council
Funding Amount
$879,010.00
Summary
Babies and children can be critically ill. When they need intensive care, thin, flexible tubes (catheters) are placed in their blood vessels to deliver fluids and medications. Despite best efforts, catheters may not reach or move from the correct location inside the patient and the procedures may need to be repeated. Our solution is an innovative medical device that tracks where the catheter is during and after the procedure; this makes care safer and less stressful for the babies and children.
Is There Cytomegalovirus In Mothers Breastmilk And Does It Cause Infection In Very Premature Babies?
Funder
National Health and Medical Research Council
Funding Amount
$235,970.00
Summary
The hypothesis behind this study is that some very premature infants become infected with cytomegalovirus (CMV) from their mother's breast milk. This proposal is for a study of 200 CMV antibody positive mothers who are expressing breast milk for their very premature infants. We believe this is likely to be about 50% of all mothers. It has been well established that some full term infants are infected with CMV from their mother's breastmilk. The question now is do very premature infants with poor ....The hypothesis behind this study is that some very premature infants become infected with cytomegalovirus (CMV) from their mother's breast milk. This proposal is for a study of 200 CMV antibody positive mothers who are expressing breast milk for their very premature infants. We believe this is likely to be about 50% of all mothers. It has been well established that some full term infants are infected with CMV from their mother's breastmilk. The question now is do very premature infants with poor immunity develop serious infections from cytomegalovirus. This project has the overall aim of determining what proportion of very premature infants become ill with CMV excreted in their mother's breast milk, and then determining the nature and severity of those illnesses. It will also define how many mothers of premature infants are excreting CMV in their breast milk, the time this starts after birth, the viral load transmitted to the infant, the age after birth when the infants first become infected, the proportion who become ill with the infection, the details of the diseases and whether freezing breast milk kills the CMV.Read moreRead less