DESCRIPTION (provided by applicant): The purpose of this Mentored Patient-Oriented Research Career Development Award is to prepare Elizabeth E. Foglia, MD, Instructor of Pediatrics at the University of Pennsylvania for her long-term goal of becoming an independent clinical investigator. Her long-term career objectives are to evaluate delivery room interventions to reduce morbidity and mortality in preterm infants and to translate effective interventions into resuscitation recommendations and clinical practice. Her immediate goal is to obtain the training, mentorship, and research experience necessary to successfully compete for R01 grants supporting intervention studies in this area. To meet this goal, Dr. Foglia and her mentors have developed a comprehensive career development plan with the following components: (a) intensive mentorship from a team with whom she have a proven track record of collaboration and scholarship, (b) advanced training in longitudinal and clustered data analysis, survival data analysis, and clinical trials, (c) experience in acquisition and interpretation of respiratory funcion monitoring, (d) participation in research seminars and collaborative investigators meetings with national and international experts in clinical effectiveness research and particularly neonatal resuscitation (e) an innovative research plan to investigate the respiratory parameters that are most associated with lung aeration after birth and to test whether a simplified respiratory function monitor display improves provider performance of goal-directed PPV. Bronchopulmonary dysplasia (BPD) is a major clinical problem with enormous societal burden and cost, affecting half of surviving extremely premature infants. Preventing BPD requires strategies to reduce acute lung injury, particularly after birth when the immature lung is highly susceptible to damage. Currently available technology is inadequate for monitoring the safety and efficacy of positive pressure ventilation (PPV) performed in the delivery room, putting preterm infants at risk for acute lung injury immediately after birth. Easily interpretable monitoring of respiratory characteristics may allow for goal-directed PPV to facilitate lung aeration and to reduce lung injury after birth in preterm infants. Dr. Foglia aims to refine a respiratory function monitor as an effective tool for goal-directed PPV in preterm infants. This requires first identifying the proper targets for goal-directed PPV, and then testing the optimal method of displaying these data for easy interpretation and use. Dr. Foglia has outlined a plan to perform both of these steps in this proposal. She will leverage the opportunity to study respiratory function parameters in a large cohort of preterm infants enrolled in the NICHD funded multicenter SAIL trial. She will use these data to (1) identify the critical target respiratry values that are associated with lung aeration during PPV after birth in preterm infants, and ...