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DHA For The Improvement Of Neurodevelopmental Outcome In Preterm Infants: The DINO Trial
Funder
National Health and Medical Research Council
Funding Amount
$631,875.00
Summary
The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast ....The incidence of neurological problems that occur in children born prematurely is higher than for those born at term. The earlier that a baby is born, the greater chance it has of having some developmental delay and general inability to cope at school. This has implications for the child, the families and the health system. One of the many dietary factors implicated in the development of neural abilities in premature infants is an omega-3 fatty acid called DHA. This compound is present in breast milk and most preterm formulas and is found in high concentrations in the brain and retina. In the last third of pregnancy the developing baby would normally accumulate DHA at a rapid rate. So it seems reasonable to assume that a baby outside the mother, that is born premature, would also need to accumulate DHA at this same rate. The problem is that none of the milks currently given to premature infants have DHA in high enough concentration to supply this amount of DHA to the baby. For example, breast milk and preterm formulas contain only a third of the DHA required. In order to provide this amount for the premature infant, breast milk containing DHA at about 1% of the total fat is required. Fortunately the level of DHA in breast milk can be increased to this level by supplementing the mothers diet with fish or olis like tuna oil. This study hopes to show that premature babies who receive DHA in amounts similar to that supplied in the womb will develop better than babies who receive low amounts of DHA.Read moreRead less
Imaging Lung Aeration And Lung Motion Following Very Premature Birth
Funder
National Health and Medical Research Council
Funding Amount
$517,631.00
Summary
Using a synchrotron as an X-ray source, we will image the lungs as they aerate at birth and optimise ventilation strategies that improve lung aeration while minimising the risk of ventilation-induced lung injury.
Developmental Changes In Cerebral Oxygenation After Term And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$445,306.00
Summary
Approximately 10% of all births are preterm and the numbers of infants surviving are increasing. We have previously found that infants born preterm have lower blood pressure over the first 6 months after term equivalent age than infants born at term. We will use new technology to examine how preterm birth affects brain oxygenation and how this is altered with gestational age, sleep states and sleeping position, to provide insights into their increased risk for SIDS.
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
Improving Outcomes For Premature Infants Through Effective Maintenance Of Systemic Blood Flow
Funder
National Health and Medical Research Council
Funding Amount
$789,383.00
Summary
Survival rates for preterm babies are increasing, but the rate of disability is still high. Preterm babies may experience inadequate blood flow to the brain, leading to longterm disability. The causes of low blood flow are not known and current treatments are ineffective in nearly half of cases. This study will confirm that low blood flow is the result of immaturity of the structure and-or control of the heart, and will test new treatments targeted to these systems in the baby.
Does Variable Ventilation Offer Physiological And Biological Benefits For The Preterm Lung?
Funder
National Health and Medical Research Council
Funding Amount
$320,278.00
Summary
Lung disease is a significant cause of illness at birth, subsequent breathing problems and death in very premature babies. We know that chronic preterm lung disease results in part from the immature state of the lung at birth, but it appears that inflammation of the lung also plays an important role. We, and others, have shown that this lung inflammation can be a response to injury from mechanical ventilation after birth. In the past, we have sought to strictly control the way that babies are ve ....Lung disease is a significant cause of illness at birth, subsequent breathing problems and death in very premature babies. We know that chronic preterm lung disease results in part from the immature state of the lung at birth, but it appears that inflammation of the lung also plays an important role. We, and others, have shown that this lung inflammation can be a response to injury from mechanical ventilation after birth. In the past, we have sought to strictly control the way that babies are ventilated. We have regulated the pressures used to inflate their lungs, the amount of volume delivered to the lung, the amount of time that the baby has to take a breath. This is a marked contrast to breathing patterns in healthy infants and adults, in which each of these things vary considerably from breath to breath. Recent studies have shown that the presence of variability in breathing patterns is actual essential to the process of staying healthy and maintaining resting lung volume above a critical lower limit. This study will provide unique insights into a new and potentially highly beneficial approaches to ventilation for preterm infants. We will determine if there is a significant clinical benefit of incorporating variability into the ventilatory waveform used to treat newborn babies with lung disease. has the potential to cause a paradigm shift in current concepts of preterm infant ventilatory strategies. Potential long term outcomes include significantly reducing illness and death associated with preterm birth, and promoting a healthier start to life for the over 6000 infants who require ventilatory assistance each year within the Australian and New Zealand neonatal network.Read moreRead less
Long-term Follow-up Of Children Born Preterm Who Received High Dose DHA: The DINO Trial Follow-up.
Funder
National Health and Medical Research Council
Funding Amount
$725,972.00
Summary
Children born prematurely are more likely to need help at school and to repeat a grade. One of the factors that may be responsible for the poor development of children who were premature may be the lack of an omega-3 fatty acid, called DHA. We have done a study in which feeds of premature infants were supplemented with DHA at a level equivalent to what a baby would recieve in the womb. We now want to see if these children have improved development at school age.
Innate Immunity In Premature Infants: The Role Of Toll Like Receptors In Susceptibility To Infection
Funder
National Health and Medical Research Council
Funding Amount
$440,312.00
Summary
Premature infants are extremely vulnerable to severe infection in early life. This study will examine how well premature infants mount an initial immune response against infection (innate immunity) compared to infants born on time and adults. This study will also look at factors that affect this response and whether we can predict which babies will develop severe infection or other complications. This information will help develop new strategies to treat and prevent infections in these infants.