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.
Human Amnion Cells As A Therapy For Preterm Lung Disease
Funder
National Health and Medical Research Council
Funding Amount
$104,664.00
Summary
Premature babies often have serious breathing difficulties due to immature lungs, and these can remain life long. Amnion cells, which are from the membrane that surrounds the baby and placenta in the womb, behave like stem cells and can develop into lung cells. Using an animal model, we will give these cells to damaged premature lungs, and see if they can repair the lung tissue. We are hopeful this will improve the survival of premature babies and help prevent long term lung disease.
The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, ther ....The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, therefore, that an inability to breathe is one of the primary problems faced by a prematurely born infant. During late gestation the lung changes dramatically in order to increase its ability to exchange gases. There is an increase in surface area and a reduction in the barrier thickness between the airspace and the blood stream. The molecular mechanisms involved in this remodelling are unknown, but it is known that the administration of corticosteroids to women at risk of preterm labour causes a large decrease in this barrier thickness and increases the distensibility of the lung. This project seeks to understand how the structure of the lung matures in late gestation and to determine whether corticosteroids regulate these changes by altering the structure of a specialised molecule, called versican. Versican resides in the tissue space outside of cells and has special properties that allow it to retain water and help organise the surrounding matrix. We propose that alterations in the structure of versican will reduce its ability to retain water, thereby reducing the tissue volume and contributing to a reduction in the air-blood tissue barrier within the lung.Read moreRead less
Improving Lung Protective Mechanical Ventilation In The Newborn Using Regional Lung Mechanics
Funder
National Health and Medical Research Council
Funding Amount
$249,130.00
Summary
Premature babies are at risk of severe, and potentially long-term, lung damage. These complications can be minimised if babies lungs are optimally supported from birth. Dr Tingay will examine the influence of different strategies for using mechanical ventilators to help inflate the lung at birth, and their interactions with other therapies used to enhance lung maturity, using exciting new imaging technologies. It will provide new insights into helping vulnerable preterm babies.
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
A Randomised Trial To Implement Systematic Distress Screening And Structured Care For Callers Using Cancer Councils' Telephone Services
Funder
National Health and Medical Research Council
Funding Amount
$289,279.00
Summary
Distress interferes with the ability to cope with cancer, its symptoms and treatment. Checking for distress and offering the right type of support should help reduce distress. In collaboration with state Cancer Councils, this study will test the costs and benefits of putting structured care into practice for people using Cancer Council telephone support services.
Trans20: A Longitudinal Cohort Study To Improve Outcomes For Transgender Children And Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$1,566,662.00
Summary
1% of young people now identify as transgender or gender diverse (TGD), and increasing numbers are presenting for specialist gender-affirming clinical care. This study will prospectively evaluate the health outcomes and well being of a large cohort of TGD children and adolescents who received such care. By doing so, this research will address critical knowledge gaps in this important and emerging area of health care so as to maximise health outcomes and minimise harm for this vulnerable group.
Improving And Evaluating The Health Of Mothers And Babies
Funder
National Health and Medical Research Council
Funding Amount
$320,848.00
Summary
This research program considers new ways to monitor an unborn baby’s health and to provide better care for childbearing women. Several projects will test the unborn baby’s well being. A new study will consider two forms of cooling treatments to help relieve pain following childbirth. Further research involves studies of the genetics of increased blood pressure in pregnant women and a structured way of looking at existing evidence to consider how well it delivers.