The NICHD Neonatal Research Network
centers perform clinical research to seek ways to improve the
outcomes of both term and preterm high-risk infants. Last year the
Children's Mercy-Truman-UMKC Center became one of 18 NIH-funded
Neonatal Research Network centers in the nation.
Led by William Truog, MD, Sosland
Chair in Neonatal Research at Children's Mercy and Professor and
Associate Chair of the Department of Pediatrics at the University
of Missouri Kansas City School of Medicine, Children's Mercy is
currently involved in four important interventional studies, in
conjunction with other institutions within the NICHD Network. Each
of these studies could have lasting implications for high-risk
Two studies concern babies that have
suffered birth asphyxia just before or after delivery, which puts
them at high risk for brain injury, cerebral palsy or other
debilitating conditions. About a decade ago it was found that
providing therapeutic cooling for these babies resulted in more
positive long-term outcomes.
One study is looking at the
potential benefits of cooling for longer periods (five days vs.
three days), or at lower temperatures (32º C vs. 33.5º C). The
study also looks at other slight variations in the lengths of
cooling periods and temperatures. This study was already under way
when Children's Mercy joined the Network.
Another similar study is attempting
to determine whether there are additional benefits in starting the
cooling therapy between 6 and 24 hours after birth. "This is a
prime example of a study that wouldn't be possible without such an
expansive network of participating institutions, as the test pool
consists solely of babies who for some reason couldn't begin being
cooled within the first six hours," Dr. Truog says.
A recently begun study is measuring
the benefits of using hydrocortisone on babies born before 30
weeks. For years, hydrocortisone took a back seat to dexamethasone,
until problems with that drug were discovered after children were
evaluated at the age of two. Children's Mercy is active in getting
babies enrolled in this study of the benefits of hydrocortisone in
infants' third and fourth weeks of life, with the goal of
diminishing or reducing lung injuries due to prematurity.
Lastly, Children's Mercy is testing
one of two different kinds of surgery for premature babies who have
developed intestinal problems, includingnecrotizing enterocolitis,
an uncommon but devastating condition. There aren't many subjects
for this study, which requires two years to determine which
procedure produces the better outcome.
"The network sponsors this study for
babies that develop a need for intervention, and families allow the
initial operation to be picked by chance, to best determine which
approach produces a better overall outcome," Dr. Truog says.