人工子宫技术——治疗极早产儿的更生理性解决方案。
Artificial womb technology - A more physiologic solution to treating extreme prematurity.
作者信息
De Bie Felix R, Binion Chase C, Antiel Ryan M
机构信息
Department of Surgery, Duke University, Durham, NC, USA.
Department of Surgery, University of Virginia, Charlottesville, VA, USA.
出版信息
Eur J Obstet Gynecol Reprod Biol X. 2024 Dec 15;25:100359. doi: 10.1016/j.eurox.2024.100359. eCollection 2025 Mar.
Abstract
Treatment of extreme premature infants (EPI) is limited by developmental immaturity primarily of the lung. A paradigm shift towards a more physiologic treatment of EPI as fetal neonates or , by keeping them in a womb-like environment to allow continued organ maturation, is the rationale for artificial womb technology. In this review, we discuss the artificial placenta and womb technology, it's rationale, the history of its development, the most recent preclinical models described in the literature and finally pertinent ethical considerations.
摘要
极早产儿（EPI）的治疗主要受肺部发育不成熟的限制。将EPI作为胎儿新生儿进行更符合生理的治疗，或者通过将他们置于类似子宫的环境中以使其器官持续成熟，这是人工子宫技术的基本原理。在这篇综述中，我们讨论了人工胎盘和子宫技术、其基本原理、发展历史、文献中描述的最新临床前模型，以及最后的相关伦理考量。
相似文献
1
Artificial womb technology - A more physiologic solution to treating extreme prematurity.人工子宫技术——治疗极早产儿的更生理性解决方案。
Eur J Obstet Gynecol Reprod Biol X. 2024 Dec 15;25:100359. doi: 10.1016/j.eurox.2024.100359. eCollection 2025 Mar.
2
Artificial placenta and womb technology: Past, current, and future challenges towards clinical translation.人工胎盘和子宫技术：向临床转化的过去、现在和未来挑战。
Prenat Diagn. 2021 Jan;41(1):145-158. doi: 10.1002/pd.5821. Epub 2020 Sep 19.
3
The new frontier in ECLS: Artificial placenta and artificial womb for premature infants.体外膜肺氧合的新前沿：早产儿的人工胎盘和人工子宫。
Semin Pediatr Surg. 2023 Aug;32(4):151336. doi: 10.1016/j.sempedsurg.2023.151336. Epub 2023 Oct 17.
4
A Volume-Adjustable Artificial Womb for Extremely Preterm Infants.可调节容量的人工子宫用于极早产儿。
Transpl Int. 2024 Jul 9;37:12947. doi: 10.3389/ti.2024.12947. eCollection 2024.
5
A supportive physiologic environment for the extreme premature infant: Improving life outside the womb.为超早产儿提供支持性的生理环境：改善子宫外的生活。
J Pediatr Surg. 2022 Feb;57(2):167-171. doi: 10.1016/j.jpedsurg.2021.10.025. Epub 2021 Oct 29.
6
Artificial Placenta and Artificial Womb Technologies for Lung and Kidney Failure: A Holistic Perspective.用于肺和肾衰竭的人工胎盘和人工子宫技术：全面视角
ASAIO J. 2025 Apr 25. doi: 10.1097/MAT.0000000000002443.
7
Ethics Considerations Regarding Artificial Womb Technology for the Fetonate.关于为胎儿提供人工子宫技术的伦理考虑。
Am J Bioeth. 2023 May;23(5):67-78. doi: 10.1080/15265161.2022.2048738. Epub 2022 Apr 1.
8
Ethical considerations in the use of artificial womb/placenta technology.人工子宫/胎盘技术使用中的伦理考量。
Semin Perinatol. 2022 Apr;46(3):151521. doi: 10.1016/j.semperi.2021.151521. Epub 2021 Nov 9.
9
An EXTrauterine environment for neonatal development: EXTENDING fetal physiology beyond the womb.一种新生儿发育的子宫外环境：将胎儿生理学扩展到子宫外。
Semin Fetal Neonatal Med. 2017 Dec;22(6):404-409. doi: 10.1016/j.siny.2017.04.006. Epub 2017 May 24.
10
Development of an artificial placenta for support of premature infants: narrative review of the history, recent milestones, and future innovation.用于支持早产儿的人工胎盘的发展：历史、近期里程碑及未来创新的叙述性综述
Transl Pediatr. 2021 May;10(5):1470-1485. doi: 10.21037/tp-20-136.
本文引用的文献
1
Assessment of extremely premature lambs supported by the Extrauterine Environment for Neonatal Development (EXTEND).由新生儿宫外环境支持的极早产羔羊发育评估（EXTEND）。
Pediatr Res. 2024 Dec;96(7):1616-1625. doi: 10.1038/s41390-024-03287-0. Epub 2024 Jun 4.
2
Clinical aspects of umbilical cord cannulation during transfer from the uterus to a liquid-based perinatal life support system for extremely premature infants a qualitative generic study.极早产儿从子宫内转移到基于液体的围产生命支持系统时的脐带插管的临床方面：一项定性的一般研究。
PLoS One. 2023 Dec 21;18(12):e0290659. doi: 10.1371/journal.pone.0290659. eCollection 2023.
3
Simulation-based development: shaping clinical procedures for extra-uterine life support technology.基于模拟的开发：塑造宫外生命支持技术的临床程序。
Adv Simul (Lond). 2023 Dec 2;8(1):29. doi: 10.1186/s41077-023-00267-y.
4
Artificial placenta support of extremely preterm ovine fetuses at the border of viability for up to 336 hours with maintenance of systemic circulation but reduced somatic and organ growth.对处于存活临界状态的极早产绵羊胎儿进行人工胎盘支持长达336小时，维持体循环，但躯体和器官生长减缓。
Front Physiol. 2023 Aug 24;14:1219185. doi: 10.3389/fphys.2023.1219185. eCollection 2023.
5
Extracorporeal life support without systemic anticoagulation: a nitric oxide-based non-thrombogenic circuit for the artificial placenta in an ovine model.体外生命支持无需全身抗凝：一种基于一氧化氮的非血栓形成回路，用于羊模型中的人工胎盘。
Pediatr Res. 2024 Jan;95(1):93-101. doi: 10.1038/s41390-023-02605-2. Epub 2023 Apr 22.
6
Life Support System for the Fetonate and the Ethics of Speculation.芬顿酸盐的生命支持系统与推测的伦理
JAMA Pediatr. 2023 Jun 1;177(6):557-558. doi: 10.1001/jamapediatrics.2023.0486.
7
An Artificial Placenta Experimental System in Sheep: Critical Issues for Successful Transition and Survival up to One Week.绵羊人工胎盘实验系统：成功过渡及存活至一周的关键问题
Biomedicines. 2023 Feb 24;11(3):702. doi: 10.3390/biomedicines11030702.
8
Impact of the Addition of a Centrifugal Pump in a Preterm Miniature Pig Model of the Artificial Placenta.在早产小型猪人工胎盘模型中添加离心泵的影响。
Front Physiol. 2022 Jul 22;13:925772. doi: 10.3389/fphys.2022.925772. eCollection 2022.
9
Ethics Considerations Regarding Artificial Womb Technology for the Fetonate.关于为胎儿提供人工子宫技术的伦理考虑。
Am J Bioeth. 2023 May;23(5):67-78. doi: 10.1080/15265161.2022.2048738. Epub 2022 Apr 1.
10
Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018.美国 2013-2018 年极早产儿的死亡率、住院期间发病率、护理实践和 2 年结局。
JAMA. 2022 Jan 18;327(3):248-263. doi: 10.1001/jama.2021.23580.
Zotero 插件