SUMMARY
The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide
Colm Travers, MD, with the mentorship, training, and research experience needed to become an
independent clinician scientist and leader in neonatal pulmonary outcomes research. His long-term career
goal is to reduce the increasing burden of respiratory morbidity among the 360,000 survivors of preterm birth
per year in the US through novel observational and interventional studies and large scale multi-center clinical
trials of interventions that reduce lung injury. To achieve these goals and transition to independence, Dr.
Travers and his mentors developed a comprehensive research and career development plan that includes
mentorship from an exceptional team of scientists with proven track records of mentorship; intensive didactic
training including completion of a Master of Science in Public Health in Outcomes Research; and a research
plan that is purposefully designed to provide experiential learning in advanced research methods to study
pulmonary outcomes among preterm infants. Survivors of preterm birth are at increased risk for wheeze,
asthma, and abnormal pulmonary function tests (PFTs) during childhood. Studies of lung function in preterm
infants have been limited by the difficulties with completing infant PFTs, restricting the ability to measure
illness severity, assess response to treatments, and understand developmental lung health trajectories. Dr.
Travers recently completed two prospective cohort studies using an innovative non-invasive oscillometry
technique to quantify pulmonary mechanics in spontaneously breathing term and preterm infants. His early
work observed that differences in lung mechanics between term and preterm infants can be reproducibly
measured and persist until discharge. In the research plan outlined in this K23 proposal, Dr. Travers will
expand upon this novel work, and his specific research aims are directly aligned with his training plan as
follows: (1) To determine the extent to which differences in lung mechanics between healthy term infants
and preterm infants with and without lung disease after birth persist until discharge from hospital or 40 weeks’
postmenstrual age, (2) To quantify changes in lung mechanics among preterm infants receiving medications
for lung disease, and (3) To determine the extent to which abnormalities in pulmonary mechanics detected
before discharge persist and predict longer-term pulmonary outcomes at 24 months. A non-invasive method
to measure lung mechanics and predict longer-term pulmonary outcomes before discharge from hospital can
fundamentally change our understanding of the effect of early postnatal lung development on lung function
in preterm infants. In addition, a non-invasive bedside device that objectively measures response to
treatments would be both a vital research and clinical tool. Building upon the skills and insights acquired
through the proposed training and research plan, Dr. Travers will apply for an R01 to determine the effects
of early interventions and therapies on lung mechanics and pulmonary health in early childhood.
