A paradigm shift in the treatment of extreme prematurity: the artificial placenta.

Published

Journal Article (Review)

PURPOSE OF REVIEW: Extremely low gestational age newborns (ELGANs), born at less than 28 weeks' estimated gestational age, suffer the greatest consequences of prematurity. There have been significant advances in their care over the last several decades, but the prospects for major advances within traditional treatment modalities appear limited. An artificial placenta using extracorporeal life support (ECLS) has been investigated in the laboratory as a new advance in the treatment of ELGANs. We review the concept of an artificial placenta, the purported benefits, and the most recent research efforts in this area. RECENT FINDINGS: For 50 years, researchers have attempted to develop an artificial placenta based on ECLS. Traditional artificial placenta strategies have been based on arteriovenous ECLS using the umbilical vessels with moderate success. Recently, the use of venovenous ECLS and miniaturization of ECLS components have shown potential for creating a next-generation artificial placenta. SUMMARY: ELGANs suffer the greatest morbidity and mortality of prematurity, and are poised to benefit from a paradigm shift in the treatment. Although challenges remain, the artificial placenta is feasible. An artificial placenta would not only protect ELGANs from the complications of mechanical ventilation, but also support their development until a stage of greater maturity, preparing them for a life free of the sequelae of prematurity.

Full Text

Duke Authors

Cited Authors

  • Davis, RP; Bryner, B; Mychaliska, GB

Published Date

  • June 2014

Published In

Volume / Issue

  • 26 / 3

Start / End Page

  • 370 - 376

PubMed ID

  • 24786370

Pubmed Central ID

  • 24786370

Electronic International Standard Serial Number (EISSN)

  • 1531-698X

Digital Object Identifier (DOI)

  • 10.1097/MOP.0000000000000083

Language

  • eng

Conference Location

  • United States