Respiratory failure at birth is a major cause of death and disease in newborn infants. At birth the airways must be cleared of liquid to allow the inhalation of air, but, little is known about the process of lung aeration, because it has not been possible to observe or measure it. We have developed imaging and analytical techniques to observed and measure lung aeration. We will determine ventilation procedures that promote uniform lung aeration and minimise lung injury in ventilated infants.
Premature babies often need assistance to breathe but this can injure the lung and lead to abnormal lung development and long-term lung disease. We have recently identified 3 factors that we believe are fundamental to initiating this abnormal lung development. We will demonstrate that these 3 factors mediate abnormal lung development following lung injury at birth. This information can then be used to reduce the incidence and severity of chronic lung disease of the newborn.
Nasal CPAP For Very Preterm Infants At Birth: Does It Improve Outcome? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$460,604.00
Summary
Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a ....Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a year. Of infants born less than 29 weeks' gestational age, about 40% of the survivors subsequently developed chronic lung disease (CLD). This condition is defined as prolonged dependence on supplementary oxygen therapy. CLD is associated with further costs and increased lung problems and readmissions to hospital in the first year of life. Thus, CLD is an expensive and time-consuming condition that has a high social cost. This project will determine whether treating these very premature babies from birth simply by applying oxygen under a low continuous positive pressure (CPAP) into their nose rather than the present treatment of placing a tube in the windpipe (known as intubation) and ventilation will reduce the incidence and severity of neonatal respiratory distress syndrome and subsequent chronic lung disease. The project will involve 600 babies from different, high quality neonatal intensive care units. Babies who are born at less than 29 weeks' gestation and who show signs of breathing at birth will be randomly allocated to be treated with either nasal CPAP or intubation and ventilation. This project will determine whether CPAP treatment at birth improves survival and reduces the severity of the RDS and subsequent CLD, or has no long term beneficial effect. If the trial is successful, this will be one of the most useful new treatments in neonatal medicine because it is simple to use, easier for the babies, and cheaper than ventilation.Read moreRead less
Improving Respiratory Transition And Outcomes Of Newborn Infants
Funder
National Health and Medical Research Council
Funding Amount
$262,251.00
Summary
Effective mask ventilation is the most important intervention at birth that can reduce mortality and disability in term and preterm infants. I will develop strategies to help clinicians improve their resuscitation skills. I will also study new ways to better support babies’ transition after birth, to improve their short and long term outcomes. The results of this research will change the way newly born babies are cared for around the world.
Role Of Placental Heme-oxygenase Pathway In Regulating Preterm Neonatal Cardiovascular Function
Funder
National Health and Medical Research Council
Funding Amount
$176,719.00
Summary
Babies born prematurely are more likely to experience problems as a result of being born early with males doing worse than females. The mechanisms causing this difference are unknown. The control of blood flow in the placenta and fetus is essential for normal growth and development. This project will investigate the influence of duration of pregnancy, gender, and exposure to antenatal steroids on pathways that control blood flow in the placenta and the newborn in babies born after prematurely.
Role Of Viruses In The Development Of Lung Disease In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$1,223,186.00
Summary
This study will investigate how lung disease starts in babies with cystic fibrosis and the role of viral infections in this process. The new knowledge gained will help us move towards treatments that prevent or delay the start of lung disease, something not currently possible. We believe this new treatment paradigm will lead to improved quality and extent of life of those with cystic fibrosis.
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.
A POPULATION-BASED COHORT INVESTIGATION OF LUNG FUNCTION IN RELATION TO EARLY LIFE LOWER RESPIRATORY TRACT ILLNESS AND AEROALLERGN SENSITISATION
Funder
National Health and Medical Research Council
Funding Amount
$456,013.00
Summary
Infancy appears to be the critical developmental window during which important alterations in lung structure and function develop. In this study we will assess how early lung function evolves in relation to potential insults such as lower respiratory tract infections and allergic inflammation. These are the mechanisms by which asthma is thought to develop. We will use exciting new lung function tests to evaluate lung function abnormalities associated with peripheral dysfunction characteristic of ....Infancy appears to be the critical developmental window during which important alterations in lung structure and function develop. In this study we will assess how early lung function evolves in relation to potential insults such as lower respiratory tract infections and allergic inflammation. These are the mechanisms by which asthma is thought to develop. We will use exciting new lung function tests to evaluate lung function abnormalities associated with peripheral dysfunction characteristic of chronic airway disease such as asthma.Read moreRead less
Long Term Outcomes Of Infant Lung Function In Cystic Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$509,456.00
Summary
We have shown that babies with cystic fibrosis (CF) who are apparently well can still have lung problems. As lung disease is the major cause of death in CF we need ways to monitor the condition in babies, identify those at greatest risk of lung changes and predict which children should receive newer treatments. We have developed a unique program for the measurement of lung function in babies. We now aim to find out the long term consequences of lung function changes detected in infants with CF.