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Artificial placenta: Recent advances and potential clinical applications
Catarina Metelo-Coimbra1, Roberto Roncon-Albuquerque1,2
1Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine of Porto, Porto, Portugal.
Insights
The artificial placenta offers a promising alternative to mechanical ventilation for extremely premature infants suffering from respiratory failure. This technology aims to reduce lung injury and improve circulatory function in vulnerable newborns.
Area of Science:
- Neonatology
- Pediatric Respiratory Medicine
- Biomedical Engineering
Background:
- Lung immaturity is a primary cause of death and illness in extremely premature infants.
- Mechanical ventilation, while standard, can cause lung injury and harm circulation.
- Extracorporeal lung support has been explored for decades as an alternative.
Purpose of the Study:
- To review the concept and clinical potential of the artificial placenta for premature infants.
- To update on advancements in extracorporeal lung support technology.
- To identify milestones and challenges for clinical application.
Main Methods:
- Literature review of studies from 1958 to 2015.
- Focus on artificial placenta concept and experimental models.
- Analysis of technological advancements like miniaturized pumps and oxygenators.
Main Results:
- Development of miniaturized components for extracorporeal gas exchange.
- Successful use in experimental artificial placenta models.
- The artificial placenta shows potential as an alternative to mechanical ventilation.
Conclusions:
- The artificial placenta is a promising alternative for respiratory support in extremely premature infants.
- Further research is needed to overcome limitations before widespread clinical use.
- Advances in technology support the feasibility of this approach.
Abstract:
Lung immaturity remains a major cause of morbidity and mortality in extremely premature infants. Positive-pressure mechanical ventilation, the method of choice for respiratory support in premature infants, frequently promotes by itself lung injury and a negative impact in the circulatory function. Extracorporeal lung support has been proposed for more than 50 years as a potential alternative to mechanical ventilation in the treatment of severe respiratory failure of extremely premature infants. Recent advances in this field included the development of miniaturized centrifugal pumps and polymethylpentene oxygenators, as well as the successful use of pump-assisted veno-venous extracorporeal gas exchange systems in experimental artificial placenta models. This review, which includes studies published from 1958 to 2015, presents an update on the artificial placenta concept and its potential clinical applications. Special focus will be devoted to the milestones achieved so far and to the limitations that must be overcome before its clinical application. Notwithstanding, the artificial placenta stands as a promising alternative to mechanical ventilation in extremely premature infants. Pediatr Pulmonol. 2016;51:643-649. © 2016 Wiley Periodicals, Inc.
