TY - JOUR
T1 - An extra-uterine system to physiologically support the extreme premature lamb
AU - Partridge, Emily A.
AU - Davey, Marcus G.
AU - Hornick, Matthew A.
AU - McGovern, Patrick E.
AU - Mejaddam, Ali Y.
AU - Vrecenak, Jesse D.
AU - Mesas-Burgos, Carmen
AU - Olive, Aliza
AU - Caskey, Robert C.
AU - Weiland, Theodore R.
AU - Han, Jiancheng
AU - Schupper, Alexander J.
AU - Connelly, James T.
AU - Dysart, Kevin C.
AU - Rychik, Jack
AU - Hedrick, Holly L.
AU - Peranteau, William H.
AU - Flake, Alan W.
N1 - Publisher Copyright:
© The Author(s) 2017.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85019496089&partnerID=8YFLogxK
U2 - 10.1038/ncomms15112
DO - 10.1038/ncomms15112
M3 - Article
C2 - 28440792
AN - SCOPUS:85019496089
SN - 2041-1723
VL - 8
JO - Nature communications
JF - Nature communications
M1 - 15112
ER -