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HOPE Scientific Studies

Less Is More

Study: A randomised controlled multicentre intervention study aimed at preserving factors in circulating blood factors essential for normal development in extremely premature infants.

Collaborating parties: Lund University, Skåne University Hospital (SUS), University of Gothenburg, Drottning Silvias Barn- och Ungdomssjukhus, both the Solna and Huddinge sites of Karolinska Institutet.

Read more about the study: https://www.med.lu.se/nyheter/181130od

Background

The provision of care for extremely preterm infants during the first few weeks of life involves frequent blood sampling to monitor a number of the body’s different vital functions. The loss of the infant’s blood involved with normal blood sampling usually needs to be replaced by blood transfusions. Blood from adult donors is always used for such transfusions. Donor blood from adults contains adult haemoglobin rather than the premature infant’s own haemoglobin, which is foetal. There is likely to be other components in the blood of the infant that are important for development of the baby that are not present in adult donor blood.  

The research team and others in previous studies have shown that to a large extent, a reduction in foetal haemoglobin and the number of blood transfusions administered during the first two weeks of life is linked to blood sampling. The research team also found that the greater the decrease in foetal haemoglobin and the more blood transfusions given, the greater the risk of the infant developing bronchopulmonary dysplasia (BPD) – a form of chronic lung disease that means that the baby will still need supplementary oxygen at week  36 of pregnancy. The research team therefore believes that the quantity of blood taken during clinical sampling needs to be as small as possible in extremely preterm infants. To achieve this requires the development and introduction of analytical methods as part of a clinical routine requiring only small volumes of blood.

Purpose

The purpose of this study is to investigate whether a reduction in the volume of blood taken during clinical routine sampling can lead to a reduced incidence of BPD and other morbidity during the neonatal period and improved development during childhood and adolescence. By using newly developed equipment for blood gas analysis and analysis of suspected infection (CRP analysis), which requires considerably smaller blood volumes, on average the volume of blood drawn can be reduced by 50%.

Use of HOPE

HOPE Platform is used by a) clinical nurses, b) research nurses and c) researchers. Clinical nurses use HOPE App on a tablet available at every child’s bedside to register a number of values and conditions needed for the study. R nurses use HOPE Practitioner to register additional values and conditions. Researchers use HOPE Practitioner to get a complete oversight and full control the data gathered and the over the rate at which it is  collected. In total, more than a thousand values and conditions are collected for every child.