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
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.
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.
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.
Characterising Lung Growth And Development In Health And Disease
Funder
National Health and Medical Research Council
Funding Amount
$451,716.00
Summary
A/Prof Graham Hall is senior researcher at the Telethon Institute for Child Health Research in Perth, Western Australia and is internationally recognised for his research in the area of respiratory physiology in infants and young children. His research focuses on understanding the impact of respiratory diseases, such as asthma and cystic fibrosis, as well as pre-term birth and air pollution on lung function not only in early life but as the lung grows and develops.
Bronchopulmonary Dysplasia – A Regenerative Medicine Approach
Funder
National Health and Medical Research Council
Funding Amount
$480,406.00
Summary
Bronchopulmonary dysplasia is a major leading cause of morbidity and mortality in premature babies. There is no cure. We have previously shown that amnion epithelial cells can reduce the extent of lung damage during early stages of lung development. We aim to understand how amnion cells can promote repair by interacting with existing cell types in order to restore normal lung structure and function. The outcomes from this study will help design clinical trials and develop new therapies.
Early School-Age Outcomes After Exposure To Repeat Prenatal Corticosteroids - A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,083,964.00
Summary
AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. However, we are not sure if this potentially important improvement will t ....AIMS OF THE RESEARCH We have recently concluded a large clinical trial in Australia and New Zealand of repeat dose of antenatal corticosteroids given to women who were likely to deliver their baby too early (before 34 weeks of pregnancy). We have been able to show that repeat doses of corticosteroids before birth significantly reduces the risk of the baby developing respiratory difficulties after birth from 41.4% to 32.8%. However, we are not sure if this potentially important improvement will translate into better outcomes for the children as they grow older and reach school-age. As there are many examples of treatments given around the time of birth that have been shown to have some short-term benefits, but substantial long-term harms, we must be as certain as we can be that any advance in one small area of health is not counterbalanced by disadvantages in other health areas. This is particularly important to find out for repeat antenatal corticosteroids given the earlier conflicting reports from non-randomised studies. We plan to assess the 1085 survivors from our earlier clinical trial of repeat dose of prenatal corticosteroids when they are of early school age. We will assess their movement and other important areas of their brain function, as well as their school progress, blood pressure, lung function and general health and growth. EXPECTED OUTCOMES OF THE RESEARCH If we find important improvements in health outcomes at school-age in children exposed to repeat corticosteroids, without any substantial couterbalancing adverse effects, repeat steroids will be recommended standard therapy in women who are likely to give birth to their baby very early. This will lead to a reduction in the burden of ill health.Read moreRead less
Human Amnion Epithelial Cell Therapy For Bronchopulmonary Dyspliasa
Funder
National Health and Medical Research Council
Funding Amount
$1,048,035.00
Summary
Preterm infants, especially those born very early, commonly develop a type of chronic lung disease called bronchopulmonary displasia (BPD). There is currently no cure or means of preventing BPD. Cells from the amniotic membrane that surrounds the developing baby before birth show promise as a treatment, or perhaps even a way of preventing, BPD. This project will use a preterm lamb model of BPD to assess the ability of amnion cells to treat or prevent the disease.