Grant: Operating Grant

More than half of pre-term infants, born at 28 weeks or less, have breathing problems severe enough to require mechanical ventilation for them to survive. In deciding when to remove them from the ventilator, the physician must balance conflicting issues. On one hand, it is desirable to discontinue ventilation as early as possible to avoid the adverse side effects of ventilation. On the other hand, an infant who is removed from the ventilator too early may need to be reconnected. This is not straightforward and is associated with additional adverse side effects. At present, the physician has few tools to assist in this decision and consequently more than 25% of the attempts to disconnect preterm infants from ventilation fail. Previous results have shown that infants who can be removed from ventilation successfully have different patterns of heart rate and breathing than those who fail. We will build on these results by combining non-invasive cardio-respiratory measurements, novel advanced signal processing algorithms, and machine learning methods. These will be used to create a tool that will predict the probability that mechanical ventilation can be successfully discontinued for a particular infant. This tool will provide physicians with the quantitative information needed for the informed management of ventilation of pre-term infants and hence improve patient care