Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.
Artif Organs. 2011 Nov;35(11):997-1001. doi: 10.1111/j.1525-1594.2011.01324.x. Epub 2011 Oct 14.
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 CO(2) 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.
早产儿的气体交换通常受到肺的结构和功能不成熟的影响。机械通气对于维持氧合和 CO2 清除至关重要，但同时也会导致肺组织的机械和炎症性破坏。迄今为止，体外氧合不是一种治疗选择，原因之一是可用的氧合器和插管的大小。我们假设通过维持胎儿心肺旁路并插入合适的被动驱动（动静脉）膜式氧合器，可以实现气体交换的显著改善。在工程师和新生儿科医生的密切合作下，我们开发了一种小型化的氧合器，并对插管进行了改造，使其作为一种无泵体外肺支持装置，通过脐血管插管与循环系统相连。初步的体外和体内研究结果显示出有希望的结果。我们认为这是人工胎盘临床应用的重要一步。
