This extraordinary achievement should move the art of premature infant care into a new era.
DOI:10.1038/ncomms15112
Nature Communications
ARTICLE
Received 25 Apr 2016 | Accepted 2 Mar 2017 | Published 25 Apr 2017
An extra-uterine system to physiologically support
the extreme premature lamb
Emily A. Partridge1,*, Marcus G. Davey1,*, Matthew A. Hornick1, Patrick E. McGovern1, Ali Y. Mejaddam1,
Jesse D. Vrecenak1, Carmen Mesas-Burgos1, Aliza Olive1, Robert C. Caskey1, Theodore R. Weiland1,
Jiancheng Han1, Alexander J. Schupper1, James T. Connelly1, Kevin C. Dysart2, Jack Rychik3, Holly L. Hedrick1,
William H. Peranteau1 & Alan W. Flake1
In the
In the developed world, extreme prematurity is the leading cause of neonatal mortality and
morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to
extend gestation using extracorporeal systems have achieved limited success. Here we report
the development of a system that incorporates a pumpless oxygenator circuit connected to
the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic
fluid’ circuit that closely reproduces the environment of the womb. We show that fetal lambs
that are developmentally equivalent to the extreme premature human infant can be
physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support
maintain stable haemodynamics, have normal blood gas and oxygenation parameters and
maintain patency of the fetal circulation. With appropriate nutritional support, lambs on
the system demonstrate normal somatic growth, lung maturation and brain growth and
myelination.
DOI: 10.1038/ncomms15112 OPEN
1
No comments:
Post a Comment