Each year 26,000 babies are born prematurely in Australia, approximately 500 of which are treated in the Neonatal Intensive Care Unit (NICU) at Royal North Shore Hospital.
Dr Staub and Dr Kluckow’s research within the Department of Neonatology at the Royal North Shore Hospital aims to improve the cardiovascular health and outcomes of premature infants, who are at higher risk of developing hypertension and heart disease later in life.
Results from studies conducted by Dr Staub and Dr Kluckow have helped shape several new diagnostic and therapeutic approaches on how cardiovascular problems are treated for some of their tiniest patients locally, and around the world. Due to these improved practices, even the smallest of their premature patients increasingly survive their NICU stay and grow up free of major disabilities.
One of their main ongoing studies is the DIVALI study, which investigates the development of small blood vessels in the kidneys of preterm infants using a special ultrasound technique. The researchers hypothesize that preterm birth results in impaired growth of these blood vessels, which may affect the regulation of blood pressure and kidney function over time. They have already recruited about half of their target sample size of 80 preterm and term infants admitted to the NICU, and they have started to follow up with them when they turn one year old. Their goal is to track their kidney and cardiovascular status throughout childhood and adolescence and identify potential interventions to prevent or treat hypertension and heart disease in this vulnerable population.
Another study that they have completed data collection for, is the PLUSS Hearts Study, which is a sub-study of a major lung trial that tests the effect of a steroid drug delivered directly into the lungs of premature infants in the first 24 hours of life. This treatment may reduce lung inflammation and damage, as well as increase the closure rate of the patent ductus arteriosus (PDA), a blood vessel that connects the heart and lungs and should normally close after birth. The PLUSS Hearts Study measures the heart function and the impact of the PDA in the first week of life and compares the outcomes of the infants who received the steroid drug versus those who did not.
Dr Staub and Dr Kluckow’s team are also preparing to join 2 exciting new research trials. The first being the Volume Responsiveness Trial which looks at the use of giving boluses of fluid to sick babies and whether ultrasound can identify volume responsive babies. The second trial is the ACEDuct study from Canada which is the first dual treatment trial for closure of the PDA. They hope to start recruiting later in 2024.
Heart Research Australia funding has also contributed funding of a research nurse, who plays a vital role in facilitating and coordinating these studies and trials, as well as providing clinical care and education. The funding that supports her position, as well as the purchase of a new ultrasound machine being purchased in 2024, enhances their research capabilities and quality. Heart Research Australia donors support has made a significant difference to the lives of many premature infants and their families.
Project Title: Prevention of arterial hypertension and cardiovascular disease in premature infants later in life
Lead Researchers: Dr Eveline Staub and Dr Martin Kluckow
Journal articles:
Staub, Eveline. (2023). Current and potential methods to assess kidney structure and morphology in term and preterm neonates. Anatomical record (Hoboken, N.J. : 2007). 10.1002/ar.25195.