ISTM

ISTM Research themes: 1. Clinical & Diagnostic Science

Neonatal research is currently focussing on problems related to neonatal monitoring and nutrition. A national survey of monitoring practice has been undertaken and this has confirmed widespread difficulties in sustaining intra-arterial access for placement of sensors or intermittent blood gas analysis (1). This applies particularly to the smallest and most vulnerable infants. Previous research by our group has shown problems with poor biocompatibility of catheters leading to blockage and sensor failure (2). There is potential to overcome this problem through the development of a biocompatible coating (3). In the meantime a study looking at the amount of fibrin deposition associated with different types of catheters in common use is about to commence. We have also had a long-standing interest in the neonatal application of Near Infra Red Spectroscopy, and a review of our work and that of others has recently been published (4).

 The promotion of preterm breast-feeding is another important area and breast milk expression techniques have been developed to assist mothers in producing the required amount of milk (6). A training package has been developed and evaluated using a grant from the department of health, which is underpinned and supported by a CDROM entitled “Breastfeeding”. In order to assist parents our group has authored a booklet sponsored by the charity Bliss (7), for free distribution to all units in the UK. Currently we are also working on a project to support breast-feeding mothers when they return to work.

Research Governance has had a significant impact on neonatal research. A review has been published to assist researchers in the field (8) and an information leaflet to help parents better understand the research process has been developed and reviewed.

It is thought that many of the complications of prematurity are associated with free radical damage from oxygen. Preterm infants are particularly susceptible, as they often require high concentrations of oxygen. There is potential to ameliorate some of these problems through the use of anti-oxidants. Consequently our group has developed a method to assess oxidation damage by measuring non-volatile metabolites associated with oxidation of fatty acids (5). The plan is to look specifically for differences between breast and artificial feeds.The promotion of preterm breast-feeding is another important area and breast milk expression techniques have been developed to assist mothers in producing the required amount of milk (6). A training package has been developed and evaluated using a grant from the department of health, which is underpinned and supported by a CDROM entitled “Breastfeeding”. In order to assist parents our group has authored a booklet sponsored by the charity Bliss (7), for free distribution to all units in the UK. Currently we are also working on a project to support breast-feeding mothers when they return to work.

References:

1. Ganesan V, Malbon S, Jones PW, Spencer SA. Blood gas monitoring in very low birth weight infants receiving respiratory support: a survey of current practice in the UK and Ireland. J Clin Excell 2002;4:403-10.

2. Spencer SA, Rolfe P, Murphy A, Wright T, McKenna S. In vivo assessment of catheter-tip PO2 sensor: sampling lumen fabrication. Med Biol Eng Comput 1995;33:157-62.

3. Yang Y, Zhang SF, Kingston MA, Jones G, Wright G, Spencer SA. Glucose sensor with improved haemocompatibility. Biosensors & Bioelectronics 2000;15:221-7.

4. Nicklin SE, Hassan IA, Wickramasinghe YA, Spencer SA. The light still shines, but not that brightly? The current status of perinatal near infrared spectroscopy. Arch Dis Child 2003;88:F263-F268.

5. Korchazhkina O, Exley C, Spencer SA. Measurement by reversed-phase liquid chromatography of malondialdehyde in normal human urine following derivatization with 2,4-dinitrophenylhydrazine"
(In Press). J Chromat 2003;In Press.

6. Jones E, Dimmock PW, Spencer SA. A randomised controlled trial to compare methods of milk expression after preterm delivery. Arch.Dis.Child Fetal Neonatal Ed 2001;85:F91-F95.

7. Jones E, Spencer SA. Breastfeeding your premature baby. London: Bliss, 2002.

8. Spencer SA. Practical implications of research governance in paediatric research. Current Paediatrics 2002;12:232-7.