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Pre-Vent: the prematurity-related ventilatory control study

Dennery, P. A.; Di Fiore, J. M.; Ambalavanan, N.; Bancalari, E.; Carroll, J. L.; Claure, N.; Hamvas, A.; Hibbs, A. M.; Indic, P.; Kemp, J.; Krahn, K. N.; Lake, D.; Laposky, A.; Martin, R. J.; Natarajan, A.; Rand, C.; Schau, M.; Weese-Mayer, D. E.; Zimmet, A. M.; Moorman, J. R.

Pediatr Res. 2019 Feb 9; 85(6):769-776


BACKGROUND: The increasing incidence of bronchopulmonary dysplasia in premature babies may be due in part to immature ventilatory control, contributing to hypoxemia. The latter responds to ventilation and/or oxygen therapy, treatments associated with adverse sequelae. This is an overview of the Prematurity-Related Ventilatory Control Study which aims to analyze the under-utilized cardiorespiratory continuous waveform monitoring data to delineate mechanisms of immature ventilatory control in preterm infants and identify predictive markers. METHODS: Continuous ECG, heart rate, respiratory, and oxygen saturation data will be collected throughout the NICU stay in 500 infants < 29 wks gestation across 5 centers. Mild permissive hypercapnia, and hyperoxia and/or hypoxia assessments will be conducted in a subcohort of infants along with inpatient questionnaires, urine, serum, and DNA samples. RESULTS: Primary outcomes will be respiratory status at 40 wks and quantitative measures of immature breathing plotted on a standard curve for infants matched at 36-37 wks. Physiologic and/or biologic determinants will be collected to enhance the predictive model linking ventilatory control to outcomes. CONCLUSIONS: By incorporating bedside monitoring variables along with biomarkers that predict respiratory outcomes we aim to elucidate individualized cardiopulmonary phenotypes and mechanisms of ventilatory control contributing to adverse respiratory outcomes in premature infants.

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