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2018 Neonatal Pilot Research Recipient

 

The ICTS is pleased to announce the awardee of the 2018 Neonatal Pilot Research. This special pilot is co-sponsored by Children's Hospital of Orange County (CHOC) neonatal intensive care unit and UC Irvine's Department of Pediatrics Neonatal Division.

The Neonatal Pilot Research is a grant fund mechanism for interdisciplinary teams of UCI and CHOC researchers to encourage early exploration of high-risk translational research ideas addressing long term and immediate health needs caused by premature birth.

We could not issue this award notice, a tribute to the power of UCI and CHOC collaborations to advance child health, without noting the passing of one of pediatrics' great champions, Dr. Nick Anas. There was no more heartfelt, dedicated, and wise champion for children than Nick. He was a great member of the UCI department of pediatrics and a seminal leader at CHOC. We know that Nick would have been delighted with this announcement. Let's rededicate our efforts to bring CHOC and UCI even closer together to create our shared vision of "A World Class Children's Health Center."

   

 

Primary Investigator
Brian Wong, MD, UCI School of Medicine, UCI Biomedical Engineering Samueli School of Engineering

Co-Investigator
Gurpreet Ahuja, MD, CHOC Pediatric Otolaryngology

 

 

Proposed Research:
Optical Coherence Tomography of the Neonatal Airway: Defining Anatomic Correlates of Extubation Criteria

   
In the critically ill neonate, extubation criteria are not well-defined. It is an amalgam of factors based on gas exchange and ventilatory mechanics balanced heavily by clinical intuition. Extubation failures occur frequently, and are due to a myriad number of factors, one of which is inadequate airway patency. In the otherwise normal neonate without craniofacial abnormalities, the problem site is often the subglottic region. Unfortunately, there is currently no technique to gain a priori information on subglottic structure (diameter, mucosal edema vs. scar) short of performing surgical endoscopy under general anesthesia. Here we propose the use of optical coherence tomography (OCT) to generate high-resolution 3D images of the subglottis, and use the data to provide the neonatologist with a means of visualizing airway geometry and generating quantitative anatomic descriptors of mucosal composition with the aim of developing enhanced anatomically based criteria for extubation. We will build an advanced fused silica fiberoptic imaging probe to work with our current OCT system design for the upper airway, and develop software to allow automated 3D image generation and texture analysis. We will image thru the endotracheal tube at lease 50 neonates just prior to extubation, and catalog the structure and optical composition (texture analysis, feature extraction) of the sub glottis to allow statistical comparison with other factors associated with extubation criteria at CHOC. Clinical features recorded will include (but not be limited to) ventilator parameters, unassisted respiratory rate, SAO2, ETCO2, leak pressures, as well as gestational age, total intubation days, weight. The goal of this proposal will be to gain preliminary data, that would form the basis for an R01 proposal focused on identifying the anatomic correlates of extubation success and failure in the critically neonate.