Neonatal Ventilation Follow-up Post Puberty
Research type
Research Study
Full title
United Kingdom Oscillation Study: Longitudinal changes in respiratory outcomes of adolescents born extremely prematurely - Understanding the influence of neonatal ventilation mode.
IRAS ID
191167
Contact name
Anne Greenough
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
2 years, 0 months, 13 days
Research summary
Extremely premature birth affects one in every 200 babies in the UK. Advances in the care of such babies means that now the majority survive, but they frequently have ongoing health problems. We have studied a group of prematurely born children at one and 11-14 years of age and found that their small airway function and lung function had deteriorated and was poorer compared to their term born peers. By reassessing those young people at 17-20 years of age, we will be able to determine if there has been further deterioration following puberty, after which lung function naturally declines. This would mean the natural decline after puberty would start at a lower baseline and be coupled with a greater risk of more respiratory problems later in life.
Mechanical ventilation given to babies just after birth to help breathing frequently saves lives. Unfortunately, it can damage the lungs resulting in long term breathing problems. High frequency oscillation (HFO) delivers small volumes and less lung stretch compared to conventional mechanical ventilation (CMV). We demonstrated statistically significant differences in respiratory and educational outcomes in favour of those who received HFO in 11 to 14 year olds. We plan to reassess those young people post puberty to determine whether these differences remain. We will also determine whether there are differences in educational outcome and how their quality of life has been affected.
This research will likely identify a group of young people at high risk of early respiratory failure and in need of intervention. Comparison of the two groups' results will demonstrate if a ventilation mode for extremely prematurely born babies improves their long term outcomes. Such results would change national and international neonatal practice.
We have maintained a close relationship with the children and their families who took part in the original UKOS study published in the New England Journal of Medicine in 2002. Over the preceding years we have kept in contact with them through birthday cards, Christmas cards, blogs and newsletters. Parents and their children have been a part of the UKOS steering group and this has ensured a good relationship with these families and a platform to provide information and receive feedback regarding this next stage of follow up. The families are keen to be involved in projects, as evidenced by the overwhelming support of the previous follow up study published in the New England Journal of Medicine in 2013. A number of families keep us updated on their children’s progress with letters and photos.
We plan to invite the now young people who were recruited into the UK Oscillation randomised study as infants, to attend Kings College Hospital, London, where they will be assessed for lung function. We will also assess educational outcome by means of a survey of children, parents and teachers. We will combine these results with quality of life assessments.
Written consent will be obtained and examinations will take place with a parent or guardian present. There will be the option to refuse consent for parts of the study.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
16/NE/0314
Date of REC Opinion
12 Sep 2016
REC opinion
Favourable Opinion