Which Oxygen Saturation Level Should We Use For Very Premature Infants? A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,215,600.00
Summary
Retinopathy of prematurity (ROP) is a serious complication of premature birth, and is a major cause of preventable blindness. Babies who are born before 28 weeks gestation are at greatest risk for developing severe ROP. Oxygen is one of the most common therapies used daily to care for premature babies, but high oxygen levels are one of multiple factors that can disrupt normal eye development and contribute to ROP. The current dilemma is that doctors and nurses do not know what level of oxygenati ....Retinopathy of prematurity (ROP) is a serious complication of premature birth, and is a major cause of preventable blindness. Babies who are born before 28 weeks gestation are at greatest risk for developing severe ROP. Oxygen is one of the most common therapies used daily to care for premature babies, but high oxygen levels are one of multiple factors that can disrupt normal eye development and contribute to ROP. The current dilemma is that doctors and nurses do not know what level of oxygenation is both safe and most effective for these babies. Whilst higher oxygen levels may increase ROP and other respiratory problems, it is possible that lower oxygen levels may affect other long-term outcomes. Because there is no definitive evidence regarding appropriate oxygenation, a wide spectrum of opinion and practice currently exist. Australia is conducting The Benefits of Oxygen Saturation Targeting Trial (BOOST II), a research study to solve this dilemma. BOOST II is a randomised, double blind, clinical trial, which will study the effects of using two ranges of oxygen saturation, 85-89% versus a higher range 91-95% for infants born before 28 weeks gestation. Both of these oxygen level ranges are currently used in normal practice. Patient safety will be monitored closely, and each infant will have their development, vision and health assessed by specialists at 18-24 months of age (plus the number of weeks premature), to see whether there is difference in survival free of major disability between the two groups. 1200 Australian infants will participate. This study will answer important questions about the benefits and risks of higher versus lower oxygen levels, and will improve the care of thousands of Australian children and millions more worldwide.Read moreRead less
Understanding And Improving Treatment Of Premature Infants To Improve Long Term Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$638,517.00
Summary
The last 2 decades heralded many important advances in the care of preterm infants but important gaps in our knowledge remain. Studies undertaken in the preclinical and clinical settings during this Fellowship will enhance understanding of the complex nature of disease in preterm infants. Further, we will develop and evaluate new treatments that enhance growth and development of the premature baby to optimise their long term intellectual, physical, emotional and social outcomes.
DEVELOPMENT OF CARDIOVASCULAR CONTROL DURING SLEEP IN HUMAN INFANTS AFTER PRETERM BIRTH
Funder
National Health and Medical Research Council
Funding Amount
$358,537.00
Summary
Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater dur ....Infants spend the major part of their life in sleep, and the period between birth and 6 months of age sees dramatic changes in their sleep organisation. Coincidently, there are dramatic developmental changes in the infant's heart and blood pressure control systems, and the ability to compensate for stress such as falls of blood pressure (hypotension) or in the level of oxygen in the blood (hypoxaemia). In infants born preterm, the risks of hypoxaemia, and even death are significantly greater during sleep than during wakefulness, but why this is so is uncertain. This study will examine the ability of infants to respond to stress during sleep. Four groups of infants will be examined: healthy infants born at normal gestation; healthy infants born prematurely (preterm); preterm infants who have experienced mild hypoxaemia soon after birth; and preterm infants who have suffered more severe hypoxaemia because of lung disease. Infants will be studied in a sleep laboratory during day-time sleep, and their ability to control blood pressure will be determined. By contrasting the effectiveness of blood pressure control between the infant groups we aim to determine whether preterm infants have lasting problems as a result of their premature birth, or their exposure to hypoxaemia. By contrasting infants in sleep and wakefulness, we aim to assess whether the risks of poorer blood pressure control are greater in sleep.Read moreRead less
The Burden Of Late Preterm Birth On Brain Development And 2 Year Outcomes – A Prospective, Longitudinal Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$838,690.00
Summary
80% of preterm babies are born from 32-36 weeks’ gestation, and are late preterm (LPT). LPT children have more learning problems, but why this occurs is unknown. This study aims to understand the effect of LPT birth on brain development. We will do brain scans at term and assess development at 2 years of age of 200 LPT and 200 full-term children. We expect LPT babies will have subtle alterations in brain development compared with term controls which will be associated with delayed development.
I am a psychologist whose research program aims to improve the long-term well-being for children born very small or immature. My research focuses on 1) determining the nature and severity of cognitive and behavioural problems faced by children born very small-immature, 2) investigating how these problems are associated with brain injury and alterations to brain development, and 3) assessing the effectiveness of clinical interventions which aim to reduce complications and enhance development.
Necrotising enterocolitis (NEC) is a devastating bowel condition afflicting almost 1 in 10 of very preterm babies. About a third of babies with NEC do not survive. Currently, there is no cure. We propose the use of stem-like cells from the human placenta as a targeted therapy for NEC, working by minimising gut damage and accelerating gut repair.
Executive Dysfunction And Brain Development In Very Preterm 13-year-olds - A Longitudinal MRI Study.
Funder
National Health and Medical Research Council
Funding Amount
$738,656.00
Summary
An area of concern for very preterm children is executive function (i.e. skills used for problem solving), which is related to educational problems, behavioural issues and social difficulties. In very preterm children this study will 1) determine if executive function problems remain stable, worsen, or improve with age; 2) look for markers for these problems from infant brain scans; and 3) examine how executive function difficulties are related to brain re-organisation.
Amniotic Exosomes - Nanomedicine For Bronchopulmonary Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$647,058.00
Summary
Extremely premature babies are at serious risk of developing a life threatening chronic lung disease known as bronchopulmonary dysplasia. This is expensive to treat and even babies who survive often end up with lifelong complications. Our team believes that nanoparticles released by placental stem cells have the ability to reverse the disease and that this can be administered without complex medical tools so that parents can administer it themselves after discharge.
Investigation Of The Influence Preterm Birth On Lung Structure And Function In School Age Children.
Funder
National Health and Medical Research Council
Funding Amount
$204,482.00
Summary
Bronchopulmonary dysplasia (BPD) remains the most significant chronic lung complication of premature birth. While some information on the long term respiratory outcomes in BPD exist there are no comprehensive studies linking lung structure, function and respiratory symptoms and relating these changes to neonatal history. Studies of this kind are essential to ensure future healthcare for these children can be planned accordingly.