None listed
Conditions
Brief summary
One in 12 babies in New Zealand are born premature. Premature infants, especially those born less than 30 weeks gestation and/or extremely low birth weight (<1000g), carry a disproportionate burden of mortality and lifelong neurodevelopmental disability when compared to their healthy termborn peers. For healthy brain development ensuring adequate supply of oxygenated blood to the brain is critical; however, what constitutes the 'optimal' brain perfusion and oxygen level in premature infants is currently unknown. In this observational study we will utilise portable and noninvasive equipment and radiological imaging to develop better understanding of the optimal brain perfusion and oxygenation targets to prevent mortality and later neurodevelopmental disability. Of note, NIMOPrem is the New Zealand component of a twocentre international collaborative study (the other centre being Texas Children's Hospital, USA). This study protocol is only applicable to the local study based in Wellington Regional Hospital, Wellington NZ.
Interventions
Informed parental consent will be obtained in all cases prior to data collection. Once the parental consent is obtained, following data will be collected as part of the study.
Continuous physiological measurement during the first 72hrs:
1. Cerebral regional oxygenation (using INVOSTM 5100c/ OXYALERTTM NIRSensor Infant/Neonatal)
2. Arterial blood pressure*
3. End-tidal CO2*
4. Peripheral arterial saturation*
* These physiological measurements are part of routine clinical care in this cohort
Informed parental consent will be obtained in all cases prior to data collection. Once the parental consent is obtained, following data will be collected as part of the study. Continuous physiological measurement during the first 72hrs: 1. Cerebral regional oxygenation (using INVOSTM 5100c/ OXYALERTTM NIRSensor Infant/Neonatal) 2. Arterial blood pressure* 3. End-tidal CO2* 4. Peripheral arterial saturation* * These physiological measurements are part of routine clinical care in this cohort of patients. Non-continuous investigations: 1. Urinary biomarkers of hypoxic/ischaemic brain injury (urine will be collected non-invasively) 2. Brain perfusion pressure (Middle Cerebral Artery Blood Flow Velocity) using Doppler ultrasound 3. Cranial ultrasound scan (CUSS)** 4. Cardiac echocardiography** 5. MRI brain at term-equivalent age 6. Bayley Infants Neurodevelopmental Scales** ** These investigations are part of routine clinical care in this cohort of patients. However, additional CUSS may be performed for the purpose of the study. Patient characteristics: The following demographic and clinical information will be gathered as part of the study 1. Maternal demographics 2. Relevant maternal past medical, antenatal and perinatal history 3. Infant’s perinatal and postnatal history
Sponsors
Dr Maria Saito-Benz
Eligibility
Sex/Gender
All
Age
No minimum to 4 Hours
Healthy volunteers
No
Inclusion criteria
Preterm infants (<30 weeks gestation) with extremely low birth weight (<1000g) who are born in Wellington Regional Hospital
Exclusion criteria
1. Complex congenital abnormalities 2. Known genetic abnormalities 3. Poor skin integrity 4. Significant hydrops fetalis 5. Palliation due to extreme condition at birth
Outcome results
None listed