This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Increased use of antenatal steroids, surfactant, along with mechanical ventilation, has improved outcomes for premature infants. However, the possible overuse of mechanical ventilators may lead to trauma and chronic lung disease. There is some suggestion that some premature infants may have better outcomes if not intubated at birth, but placed on nasal continuous positive airway pressure (CPAP). At present, there are no consensus guidelines on which infants should be placed on CPAP at birth or intubated. A physiologic measurement, such as spontaneous exhaled volume, may be able to provide guidance in treatment course for newborns with respiratory distress.
The aim of this study is to determine if a commercial portable pulmonary function measurement device can be used to predict the need for respiratory support and surfactant soon after birth. This will be a prospective, observational study. The measurements will not be revealed to the clinical team, who will use their judgment in deciding the patient's course of care. Outcomes will include degree of respiratory support and surfactant therapy. We plan to enroll approximately 100 patients, 50 below 1500 grams birth weight.
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