Miniaturization: The Clue to Clinical Application of the Artificial Placenta

The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoret...

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Published inArtificial organs Vol. 38; no. 3; pp. 208 - 214
Main Authors Schoberer, Mark, Arens, Jutta, Erben, Aileen, Ophelders, Daan, Jellema, Reint K., Kramer, Boris W., Bruse, Jan L., Brouwer, Petra, Schmitz-Rode, Thomas, Steinseifer, Ulrich, Orlikowsky, Thorsten
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.03.2014
Wiley Subscription Services, Inc
Subjects
Animals
Artificial Organs
Artificial placenta
Drug therapy
Equipment Design
Extracorporeal life support
Extracorporeal Membrane Oxygenation - instrumentation
Female
Humans
Infant, Premature
Interventional lung assist
Miniaturization
Models, Animal
Neonatal respiratory failure
Placenta
Pregnancy
Respiratory Insufficiency - therapy
Sheep
Surgical apparatus & instruments
Artificial placenta
Neonatal respiratory failure
Interventional lung assist
Extracorporeal life support
Online AccessGet full text

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Abstract The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Disproportional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier), is potentially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low‐volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator.
AbstractList The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Disproportional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier), is potentially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low-volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator.The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Disproportional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier), is potentially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low-volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator.
The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Disproportional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier), is potentially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low-volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator. [PUBLICATION ABSTRACT]
The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986. However, inappropriate dimensioning of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Disproportional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier), is potentially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low‐volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator.
Author Jellema, Reint K.
Schoberer, Mark
Steinseifer, Ulrich
Erben, Aileen
Bruse, Jan L.
Schmitz-Rode, Thomas
Kramer, Boris W.
Arens, Jutta
Ophelders, Daan
Brouwer, Petra
Orlikowsky, Thorsten
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  surname: Orlikowsky
  fullname: Orlikowsky, Thorsten
  organization: Neonatology Section of the Department of Paediatric and Adolescent Medicine, University Hospital, RWTH Aachen University, Aachen, Germany
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2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.
2014 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation
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Issue 3
Keywords Artificial placenta
Neonatal respiratory failure
Interventional lung assist
Extracorporeal life support
Language English
License 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.
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2012; 36
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References_xml – reference: Galan HL, Jozwik M, Rigano S, et al. Umbilical vein blood flow determination in the ovine fetus: comparison of Doppler ultrasonographic and steady-state diffusion techniques. Am J Obstet Gynecol 1999;181:1149-1153.
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– reference: Awad JA, Cloutier R, Fournier L, et al. Pumpless respiratory assistance using a membrane oxygenator as an artificial placenta: a preliminary study in newborn and preterm lambs. J Invest Surg 1995;8:21-30.
– reference: Gray BW, El-Sabagh A, Rojas-Pena A, et al. Development of an artificial placenta. IV: 24 h venovenous extracorporeal life support in premature lambs. ASAIO J 2012;58:148-154.
– reference: Kiserud T, Acharya G. The fetal circulation. Prenat Diagn 2004;24:1049-1059.
– reference: Bartlett RH, Gazzaniga AB. Extracorporeal circulation for cardiopulmonary failure. Curr Probl Surg 1978;15:1-96.
– reference: Edelstone DI, Rudolph AM. Preferential streaming of ductus venosus blood to the brain and heart in fetal lambs. Am J Physiol 1979;237:H724-729.
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– reference: Rimensberger PC. Neonatal respiratory failure. Curr Opin Pediatr 2002;14:315-321.
– reference: Reoma JL, Rojas A, Kim AC, et al. Development of an artificial placenta. I: Pumpless arterio-venous extracorporeal life support in a neonatal sheep model. J Pediatr Surg 2009;44:53-59.
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  year: 2004
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  article-title: The fetal circulation
  publication-title: Prenat Diagn
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  start-page: 53
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  end-page: 154
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– volume: 14
  start-page: 315
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Snippet The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless...
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SubjectTerms Animals
Artificial Organs
Artificial placenta
Drug therapy
Equipment Design
Extracorporeal life support
Extracorporeal Membrane Oxygenation - instrumentation
Female
Humans
Infant, Premature
Interventional lung assist
Miniaturization
Models, Animal
Neonatal respiratory failure
Placenta
Pregnancy
Respiratory Insufficiency - therapy
Sheep
Surgical apparatus & instruments
Title Miniaturization: The Clue to Clinical Application of the Artificial Placenta
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