Neonatal pulmonology

The focus of research of neonatal pulmonology is to study the long-term outcome after neonatal intensive care treatment.

Aims of Neonatal pulmonology

The aim is to reduce pulmonary complications, mainly BPD, after neonatal intensive care treatment. More specifically, we aim to elucidate the mechanisms responsible for BPD, establish how to support the lungs of (preterm) infants without causing harm by using more sophisticated monitoring at the bedside, to identify very early on which infants are at risk of BPD, and finally to find effective and safe interventions to reduce BPD.

Long-term outcome after neonatal intensive care treatment
The aim is to study the long term outcomes of high risk neonates including growth, neurological, neurocognitive, academic and behavioural outcomes from 0 – 8 years as default, but also longer in specific projects.
Research is done in cohort studies in children with certain characteristics such as low gestational age, term asphyxia, or infants that used certain medication. Long term follow-up is also used as outcome measure of randomized trials that are carried out in the pregnant women, in the neonate during their NICU stay, or in the child during the follow up phase. In depth analyses are done to not only study outcomes in general but also to examine inter-domain relationships between neurocognitive function and academic and behavioral outcomes.

Current research

I.            Neonatal pulmonology

This research line covers several aspects of neonatal pulmonology.
First, we aim to improve monitoring of lung function and control of breathing, using techniques such as electrical impedance tomography, diaphragmatic electromyography, and respiratory inductance plethysmography.
Second, we aim to elucidate the mechanisms of lung injury in (preterm) infants. For this we are using animal models mimicking multiple hits that are present in the treatment of (preterm) infants.
Third, we aim to find predictors of bronchopulmonary dysplasia (BPD), a chronic lung disease that results from preterm birth. Recently we started to explore breath analysis (eNOSE) as a means to predict BPD in preterm infants Finally, we test possible interventions to improve both lung function, control of breathing, but also to reduce the risk of developing BPD. Examples of the latter are a multicenter randomized controlled trial (RCT) on hydrocortisone (STOP-BPD trial) and a RCT on sustained inflation at the time of birth (SAIL trial). 

II.            Long-term outcome after neonatal intensive care treatment

We aim to show the long-term outcomes of 1) severe fetal growth restriction (FGR), 2) BPD treatment, and 3) extreme prematurity and the efficacy of diverse interventions to enhance neurodevelopmental outcomes of very preterm born children. These long-term outcomes will be collected in three large multicenter trials in which we have a leading role.
Efficacy of the interventions will be shown by RCT’s that start during follow up, in the first year of life, in cooperation with the expertise center for developmental support of premature infants (EOP), using executive function training (BrainGameBrian) at the age of 8 – 12, and using computerized motor training at the age of five.
We will also focus on language development in children with perinatal risk factors and study the role of bilanguality.

We will also start a long-term follow-up project on detailed neurocognitive outcomes at 8 years, after birth < 30 weeks GA predicted from neonatal, infancy, and early childhood measures collected form birth onwards with a focus on school outcomes and mathematics.

Researchers

Neonatal pulmonology

Professor:
Prof. dr. A.H.L.C. van Kaam

Postdocs:
Dr. J. Hutten
Dr. ir. F.H. de Jongh
Dr. drs. M. Miedema MD
Dr. W. Onland MD PhD
Dr. M.W.G. van Tuijl

Others:
D.H.G.M. Nuytemans (research coordinator)

PhD Students
Drs. Juliette Kraaijenga
Drs. Linda de Waal
Drs. Roseanne Vliegenthart
Drs. Laura Schouten
Drs. Rutger Flink
Drs. Ruud van Leuteren
Drs. Irene Lok
Dr. Moniek van de Loo

Long-term outcome after neonatal intensive care treatment

Professor:
Prof. dr. A.H.L.C. van Kaam
Prof. J. Oosterlaan (professor in child neuropsychology)

Postdocs:
Dr. Aleid van Wassenaer-Leemhuis
Dr. Cornelieke Aarnoudse-Moens
Dr. Timo de Haan

Others:
Drs .van Sonderen

PhD Students
Drs. F. Beukers
Drs. S. van Veen
Drs. C.A. van Houdt