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.
A Multi-centre, Double-blind, Randomised Controlled Trial To Evaluate The Efficacy Of 10 Valent-pneumococcal-Protein D Conjugate Vaccine In Reducing Respiratory Exacerbations In Children Aged ? 18 Months With Suppurative Lung Disease
Funder
National Health and Medical Research Council
Funding Amount
$1,160,660.00
Summary
Chronic suppurative (ie infected) lung diseases in children are major causes of poor health and deaths worldwide. Repeated childhood infections contribute to poor lung health in adults. The most common organism causing infection is non-typeable Haemophilus influenzae (NTHi). This study aims to determine whether a vaccine against NTHi can reduce repeated respiratory infections in children. If so, vaccination may lead to substantial improvements in current/ future lung health, and considerable dir ....Chronic suppurative (ie infected) lung diseases in children are major causes of poor health and deaths worldwide. Repeated childhood infections contribute to poor lung health in adults. The most common organism causing infection is non-typeable Haemophilus influenzae (NTHi). This study aims to determine whether a vaccine against NTHi can reduce repeated respiratory infections in children. If so, vaccination may lead to substantial improvements in current/ future lung health, and considerable direct and indirect cost of disease savings.Read moreRead less
The Clinical Utility Of Small Airway Function Tests In Paediatric Respiratory Disease
Funder
National Health and Medical Research Council
Funding Amount
$64,631.00
Summary
Respiratory disease is an important child health issue with long term implications into adulthood. The evaluation of small airways involvement in disease processes, using an accurate sensitive measures of function, such as forced oscillation technique and multiple breath washout, potentially facilitates not only early detection of disease, but instigation of earlier treatment, better assessment of response to treatment, and ultimately better outcome.
Postnatal Dexamethasone In Tiny Babies: Does It Do More Good Than Harm?
Funder
National Health and Medical Research Council
Funding Amount
$394,688.00
Summary
The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shorte ....The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. However, some of these babies require prolonged periods of help with breathing and oxygen treatment to survive, and many develop a form of chronic lung disease in the newborn period. A powerful group of drugs, known as corticosteroids, have been used to treat or prevent this chronic lung disease in newborn babies, with some success in shortening the time that the babies need help with breathing. However, corticosteroids have the potential to cause long-term harm to the developing baby's brain, and may cause lifelong problems with thinking, walking, talking, seeing or hearing. We want to test in a clinical trial if corticosteroids, specifically dexamethasone, can reduce the need for help with breathing and the rate of chronic lung disease without causing long-term problems to the developing baby's brain. Babies who are very tiny (born weighing less than 1000 g), or born very early (born before 28 weeks of pregnancy, or more than 12 weeks premature) will be eligible for this study if they still need help with their breathing after one week of age from a machine called a respirator, and their doctor considers that corticosteroids might be helpful to the baby's breathing. Some babies will receive dexamethasone and other babies will be treated with a harmless placebo - chance will decide which treatment the baby receives. All other aspects of the babies' care will continue as normally. Children who survive to 2 years of age will be assessed fully to determine if they have any problems with their health, including problems with their thinking, walking, talking, seeing or hearing. We will determine if dexamethasone is helpful or not for very tiny or very premature babies who have breathing problems after the first week of life. We will also measure the economic impact of dexamethasone treatment in these babies.Read moreRead less
SCHOOL-AGE OUTCOME FOR VERY TINY/PRETERM CHILDREN BORN IN VICTORIA IN 1991-92
Funder
National Health and Medical Research Council
Funding Amount
$252,956.00
Summary
The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (bo ....The survival rate for tiny or very premature babies has improved dramatically in recent times, from below 10% in the 1960s to greater than 70% in the 1990s. Several new treatments have helped to improve their survival rate, but some have the potential to cause long-term harm to the developing baby's brain or lung, and may cause lifelong problems with thinking, walking, talking, seeing, hearing, growth or breathing. Babies who are very tiny (born weighing less than 1000 g), or born very early (born before 28 weeks of pregnancy, or more than 12 weeks premature) will be assessed long term (to 8-9 years of age), as broadly as possible, and in comparison with normal birthweight (NBW, birthweight >2499 g) children. Outcomes will encompass academic progress and behaviour, brain function, general health, growth, and respiratory health. We will compare the outcomes for very tiny-preterm children who were treated with several of these new therapies with those who were not so treated. We will assess whether alternative measures of long term outcome that assess the quality of life are applicable to very tiny-preterm children. If so, these measures could be used much more widely, since they are cheaper and less time-consuming.Read moreRead less
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
The Identification Of Thoracic Targets For Prevention And Intervention In Bronchopulmonary Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
The persistence of breathing problems from infancy to later life is a complication of premature birth with lifelong consequences. Breathing problems often occur together with lung disease, but prematurity can also affect heart and blood vessel development, and weakness of the main breathing muscle. We will find out how much the heart, lungs and diaphragm contribute to breathing problems in babies; helping us to better predict, diagnose and treat severe breathing problems in babies born preterm.
The Centre For Research In Childhood Early Respiratory Disease
Funder
National Health and Medical Research Council
Funding Amount
$2,621,023.00
Summary
The Centre for Research in Childhood Early Respiratory Disease is dedicated to the prevention of lung disease in young children with chronic respiratory disease. We aim to better understand the process of lung disease to identify predictors of disease and to treat it better. We will investigate the psychosocial effects of early interventions to better manage families. We will facilitate collaborations to provide best practice guidance and will train the next generation of doctors and researchers
Lung, Heart And Respiratory Muscle Disease After Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$1,328,858.00
Summary
Breathing problems persisting into infancy and later life is an important complication of premature birth with lifelong consequences. Breathing problems often occur together with lung disease, but prematurity can also affect heart and blood vessel development, and weakness of the main breathing muscle (the diaphragm). We will find out how much the heart and diaphragm contribute to breathing problems in babies, and will help us to better predict, diagnose and treat severe breathing problems.
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.