Improving Breathing Support For Newborn Infants In Non-Tertiary Centres: The HUNTER Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,203,844.00
Summary
Every year in Australia, thousands of newborn babies have breathing difficulties. Our trial will study a new, simple method of providing breathing support to newborn babies in special care nurseries, called high-flow (HF). HF is cheaper, easier to use, and more comfortable for babies than the current standard treatment, called CPAP. If HF is as good as CPAP at supporting babies' breathing, it will change practice in Australia and around the world.
Lung Injury Following Resuscitation In Immature Lambs
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
The primary aim of this project is to identify techniques for resuscitating premature babies that cause little or no damage to their lungs. We also want to identify factors that enhance the clearance of liquid from the lungs so air can easily enter to deliver oxygen and remove carbon dioxide at birth. About 1% of babies are born very prematurely and many develop respiratory distress syndrome (RDS). This is the major cause of illness and death in infants born at less than 32 weeks' gestation. Mos ....The primary aim of this project is to identify techniques for resuscitating premature babies that cause little or no damage to their lungs. We also want to identify factors that enhance the clearance of liquid from the lungs so air can easily enter to deliver oxygen and remove carbon dioxide at birth. About 1% of babies are born very prematurely and many develop respiratory distress syndrome (RDS). This is the major cause of illness and death in infants born at less than 32 weeks' gestation. Most of the survivors required assisted ventilation during their first weeks of life. In 1995, 2381 premature infants were ventilated in Australia and New Zealand, requiring 36,407 days of ventilator care. Thus, this is a serious condition with a high financial and social cost. It is known that RDS is caused by damage to the very immature lung which starts an inflammatory reaction. We don't know what triggers the damage and inflammation but believe that the way babies are resuscitated may damage the lungs. Currently, babies are resuscitated with a resuscitation bag squeezed by hand, with 100% oxygen. There is no pressure to stop the lungs collapsing during expiration. As the volume of gas delivered with each breath is not measured, it is possible that the volumes are too large and damage the lungs. This project will investigate whether less damage occurs to the lungs of preterm lambs when resuscitation uses a modern neonatal ventilator where each inflation is limited to a known volume. A small distending pressure will be used to stop the lungs collapsing during expiration. We will also investigate factors that enhance the clearance of liquid from the lungs after the initiation of breathing. The failure to clear lung liquid greatly limits the ability of babies to breathe and exposes those parts of the lung that are cleared to a much greater risk of injury. The results of this study will be directly applicable to the treatment and care of prematurely born babies.Read moreRead less
Family And Environment In The Development Of Obesity And Precursors Of Diabetes And Heart Disease In Adolescence
Funder
National Health and Medical Research Council
Funding Amount
$284,770.00
Summary
Obesity is a serious public health problem in Australia. The rate of obesity appears to be rising. Currently 19-23% of children and adolescents are overweight or obese. Adolescence is a critical period for the development of obesity in both males and females. It is a time when new dietary habits, likely to promote fatness, are adopted and physical activity declines. Understanding the factors that drive these behaviours is essential for effective prevention of obesity and related diseases. In 199 ....Obesity is a serious public health problem in Australia. The rate of obesity appears to be rising. Currently 19-23% of children and adolescents are overweight or obese. Adolescence is a critical period for the development of obesity in both males and females. It is a time when new dietary habits, likely to promote fatness, are adopted and physical activity declines. Understanding the factors that drive these behaviours is essential for effective prevention of obesity and related diseases. In 1996-7, our research group studied a group of over 400 children who were aged 7-8 years, were living in western Sydney and were born at Nepean Hospital. In our new study, we plan to re-study this group of children, now in early adolescence. This will allow us to assess the family and environmental factors influencing physical activity and eating behaviour at the beginning of adolescence. The aims of our study are to: Measure changes during early adolescence in eating and physical activity behaviours that are likely to increase obesity risk Measure anthropometric and biochemical markers for future risk of type 2 diabetes and cardiovascular disease in both adolescents and their parents Identify factors in the family environment that influence changes in food intake and physical activity in early adolescence The study will be done in two phases, 18 months apart. The measurements will be done in the study centre at Nepean Hospital in western Sydney. We will measure the height, weight and skinfold thickness of the adolescents and, if possible, their parents. We will also ask the young people and their parents to complete questionnaires about the family food and activity environment and their level of physical activity and food intake. In addition, the adolescents will wear a light-weight activity monitor for 3 days ( to measure the level of activity), blood pressure will be measured and cholesterol and blood sugar levels checked.Read moreRead less
RCT Of Headbox Oxygen Vs CPAP For Neonatal Respiratory Distress In Non-tertiary Hospitals
Funder
National Health and Medical Research Council
Funding Amount
$225,500.00
Summary
Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safet ....Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safety. Currently, babies who need oxygen in a local hospital are placed in a crib with a clear plastic box around their head and oxygen is run into the box (headbox oxygen). There is an alternative method of providing oxygen called CPAP (Continuous Positive Airway Pressure). This involves giving the oxygen directly into the baby's nose via soft rubber prongs. CPAP has been used since the 1970's. It is the main form of respiratory support for infants in many NICUs in Australia and the world. There is some evidence that death and lung disease may be reduced. However, the babies in these studies are sicker and smaller than babies in local hospital nurseries. CPAP is used in some local nurseries in New Zealand, however no studies have been done to see if CPAP reduces the need for inter-hospital transfer. The study will involve hospitals that have been selected because of their level of on site medical and nursing staff. These hospitals will have support and advice from two NICUs that use CPAP as their main form of respiratory support. Babies who need oxygen will be randomly allocated to either have headbox oxygen or CPAP. If the baby becomes so unwell such that certain preset criteria are met, the baby will be transferred to a NICU in the usual way. If CPAP safely reduces the need for inter-hospital transfer, many parents will be saved the anxiety associated with transfer, and the separation it often causes.Read moreRead less
Implementing, Evaluating And Translating Pragmatic Strategies To Prevent Prenatal Alcohol Exposure (PAE), And Treat Fetal Alcohol Spectrum Disorders (FASD)
Funder
National Health and Medical Research Council
Funding Amount
$340,038.00
Summary
Drinking alcohol when pregnant places the unborn child at risk of lifelong brain damage, that we call Fetal Alcohol Spectrum Disorders (FASD). We can prevent FASD by raising awareness of the harms of drinking in pregnancy, and supporting women not to drink. For those with FASD, treatment programs can help reduce learning and behavioural problems. Our research team work with communities and service providers to implement FASD Prevention and Treatment strategies, and raise awareness of FASD.