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Current Research NICU


Sucrose Practices for Pain in Neonates (SPiN): A program of research
  

Recent studies show that babies in hospital undergo an average of 4 to 5 painful procedures, such as heel lances, every day. Sucrose (sugar water) has been shown to be effective for reducing babies’ pain during painful procedures. Our team recently completed a study (SPiN: Determining the Minimally Effective Dose of Sucrose for Procedural Pain in Infants) which aimed to determine the lowest amount of sucrose needed to manage babies’ pain. The results of this study indicated that 0.12 ml of sucrose was the minimally effective dose. Part B of this program of research will examine the effect of repeated administration of the minimally effective dose of sucrose on immediate (pain intensity) and long-term (neurodevelopmental) outcomes, and explore the influence of contextual factors on nurses’ sucrose administration practices. This is a multi-site, multi-phase study led by Dr. Bonnie Stevens (SickKids and University of Toronto).

Approximate start and end date
: July 2016 – December 2018
CHEO investigators: Denise Harrison and Thierry Daboval
Funding source: CIHR
Contact information: Denise Harrison (dharrison@cheo.on.ca)
Metrics: 40 patients will be enrolled at CHEO and TOH

Identification of non-invasive biomarkers to diagnose Necrotizing Enterocolitis (NEC)

Necrotizing Enterocolitis (NEC) is still considered the most common gastrointestinal emergency during the neonatal period and carries high mortality as well as short and long-term morbidity. This is a prospective case-control study to attempt to identify a non-invasive laboratory test on newborns stool samples that can be used to screen an at-risk population for markers of early or impending NEC. Stool samples will be prospectively collected from 400 (200 locally) enrolled patients to ensure that at least 10 cases in our group given an incidence ranging from 5-7% in our institution. Protein and RNA will be extracted from the stool samples and analysis will be carried out to identify biomarkers that distinguish the cases from the controls. The study may thus identify candidate biomarkers that could be further explored in follow up studies as early diagnostic or screening tests for NEC.

Approximate start and end date: March 2015 to December 2016
CHEO investigators: E. Ferretti
Funding source: CIHR (Sherbrooke University)
Contact information: C. Horth (chorth@cheo.on.ca)
Metrics: Approximately 130 patients will be enrolled at TOH to have 10 cases of NEC

Maternal Omega-3 supplementation to reduce BronchopulmonarY Dysplasia in very preterm Infants (MOBYDIck Trial)

Bronchopulmonary dysplasia (BPD), one of the most common and most serious complications of extremely preterm infants develops in 45% of extremely preterm infants or ~1500 newborns each year in Canada. In preterm infants, BPD results in major short- and long-term respiratory morbidities and incidence
of BPD is a strong, independent predictor of major cognitive, motor and behavioural impairments later in life. Prevention is crucial, preliminary studies have shown that supplementation with DHA may be good for the baby’s lungs and brain. The breastmilk of Canadian women on a typical Western diet (low in oily fishes) has DHA levels that are too low to meet the high needs of the extremely preterm infant. In this context, dietary supplementation of breastfeeding mothers with higher DHA doses (from marine oil) is an effective way to raise DHA levels in breastmilk. The overall aim of this randomized controlled trial is to determine whether high dose DHA supplementation in lactating mothers providing breastmilk to their infant born below 29+0 weeks of gestational age improves BPD-free survival at 36 weeks post-menstrual age.

Approximate start and end date: May 2016-December 2018
CHEO investigators: B. Lemyre, T. Daboval
Funding source: CIHR
Contact information: Chantal Horth (chorth@cheo.on.ca)
Metrics: 40-60 patients will be enrolled at the Ottawa Hospital and CHEO

Antibiotic Safety in Infants with Complicated Intra-Abdominal Infections (SCAMP Trial) NICHD-2013-ABS01

Complicated intra-abdominal infections are infectious processes causing either localized or diffuse peritonitis.Complicated intra-abdominal infections can be classified as primary or secondary. Primary complicated intra-abdominal infection develops spontaneously; secondary complicated intra-abdominal infection arises as a consequence of a mechanical breach of the gastrointestinal tract. Primary complicated intra-abdominal infection occurs commonly in adult cirrhotic
patients by translocation of pathogens from the gut lumen into the peritoneal cavity. Secondary complicated intra-abdominal infection can be a consequence of
appendicitis, diverticulitis, cholecystitis, perforation of gastric or duodenal ulcer, or of prior abdominal surgery, among other causes. The most commonly
used drugs in infants with complicated intra-abdominal infections are not labeled for use in this population because safety and efficacy data are lacking. The Cerebral Spinal Fluid Pharmacokinetics (PK) for these drugs in this population is virtually non-existent. The proposed study will provide the safety and efficacy information required for labeling.

CHEO investigators: E. Bariciak
Funding source: NICHD – National Institute of Child Health and Human Development
Contact information: Chantal Horth (chorth@cheo.on.ca)
Metrics:  We expect <10 patients will be enrolled at CHEO
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