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An extra-uterine system to physiologically support the extreme premature lamb
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An extra-uterine system to physiologically support the extreme premature lamb
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Journal Article
An extra-uterine system to physiologically support the extreme premature lamb
2017
Overview
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.
The ability to support the development of a premature fetus in the form of an extracorporeal system has had limited success. Here, the authors show that an extra-uterine device that mimics the intra-uterine environment can provide physiologic support for the extreme premature lamb fetus for four weeks.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 14/63
/ 38
/ 59/57
/ 9/10
/ Animals
/ Animals, Newborn - physiology
/ Design
/ Extracorporeal Membrane Oxygenation - adverse effects
/ Extracorporeal Membrane Oxygenation - instrumentation
/ Extracorporeal Membrane Oxygenation - methods
/ Female
/ Fetuses
/ Humanities and Social Sciences
/ Humans
/ Infant, Extremely Premature - physiology
/ Neonates
/ Placenta
/ Premature Birth - physiopathology
/ Science
/ Sepsis
