Lung injury following resuscitation in immature lambs

Funded Activity 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. 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.

Funded Activity Details

Start Date: 01-01-2001

End Date: 01-01-2003

Funding Scheme: NHMRC Project Grants

Funding Amount: $227,036.00

Funder: National Health and Medical Research Council

Research Topics

ANZSRC Field of Research (FoR)

Paediatrics

ANZSRC Socio-Economic Objective (SEO)

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Other Keywords

Bronchopulmonary dysplasia | Inflammatory mediators | Lung liquid clearance | Neonatal intensive care | Neonatal respiratory distress syndrome | Respiratory Distress Syndrome | Resuscitation | Transient tachypnoea

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