NeonatOx: A Pumpless Extracorporeal Lung Support for Premature Neonates

Gas exchange in premature neonates is regularly impaired by structural and functional immaturity of the lung. Mechanical ventilation, which is vitally important to sustain oxygenation and CO2 elimination, causes, at the same time, mechanical and inflammatory destruction of lung tissue. To date, extr...

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Bibliographic Details
Published in:Artificial organs 2011-11, Vol.35 (11), p.997-1001
Main Authors: Arens, Jutta, Schoberer, Mark, Lohr, Anne, Orlikowsky, Thorsten, Seehase, Matthias, Jellema, Reint K., Collins, Jennifer J., Kramer, Boris W., Schmitz-Rode, Thomas, Steinseifer, Ulrich
Format: Article
Language:English
Subjects:
Animals
Artificial placenta
Cannula
Cannulation
Carbon Monoxide - metabolism
Catheterization - instrumentation
Equipment Design
Extracorporeal Membrane Oxygenation - instrumentation
Female
Humans
Infant, Newborn
Infant, Premature
Lung - physiology
Lung assist
Male
Oxygen - metabolism
Oxygenator
Oxygenators
Premature neonates
Pumpless
Random Allocation
Sheep
Umbilical Cord - blood supply
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Summary:Gas exchange in premature neonates is regularly impaired by structural and functional immaturity of the lung. Mechanical ventilation, which is vitally important to sustain oxygenation and CO2 elimination, causes, at the same time, mechanical and inflammatory destruction of lung tissue. To date, extracorporeal oxygenation is not a treatment option, one reason among others being the size of available oxygenators and cannulas. We hypothesized that a substantial improvement in gas exchange can be achieved by maintenance of the fetal cardiopulmonary bypass and interposition of a suitable passively driven (arteriovenous) membrane oxygenator. In close cooperation between engineers and neonatologists, we developed a miniaturized oxygenator and adapted cannulas to be used as a pumpless extracorporeal lung support that is connected to the circulation via cannulation of the umbilical cord vessels. First in vitro and in vivo studies show promising results. We regard this as one step on the way to clinical application of the artificial placenta.
ISSN:0160-564X
1525-1594
DOI:10.1111/j.1525-1594.2011.01324.x