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Report of an Experiment With a Fetal Ex-Utero Support System in Piglets

Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable p...

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Autores principales: Abrao Trad, Ayssa T, Buddington, Randal, Enninga, Elizabeth, Duncan, Jose, Schenone, Claudio V, Mari, Giancarlo, Buddington, Karyl, Schenone, Mauro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224797/
https://www.ncbi.nlm.nih.gov/pubmed/37252594
http://dx.doi.org/10.7759/cureus.38223
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author Abrao Trad, Ayssa T
Buddington, Randal
Enninga, Elizabeth
Duncan, Jose
Schenone, Claudio V
Mari, Giancarlo
Buddington, Karyl
Schenone, Mauro
author_facet Abrao Trad, Ayssa T
Buddington, Randal
Enninga, Elizabeth
Duncan, Jose
Schenone, Claudio V
Mari, Giancarlo
Buddington, Karyl
Schenone, Mauro
author_sort Abrao Trad, Ayssa T
collection PubMed
description Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable patient population. In this study, we report our experience with an ex-utero support system for fetal pigs with the goal of support and survival for eight hours. Our experiment included two pigs at a gestational age equivalent to a 32-week human fetus. Following ultrasound assessment and delivery via hysterotomy, the fetuses were transferred to a 40 L glass aquarium filled with warmed lactated Ringer's solution and connected to an arteriovenous (AV) circuit that included a centrifugal pump and a pediatric oxygenator. Fetus 1 was successfully cannulated and survived for seven hours (expected maximum duration of eight hours). Fetus 2 died shortly after hysterotomy, secondary to failure at the cannulation stage. Our results suggest that ex-utero support of the premature fetal pig is feasible, contributing to a scarce body of evidence. However, further studies are needed before effectively translating an artificial placenta system into the clinical arena.
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spelling pubmed-102247972023-05-29 Report of an Experiment With a Fetal Ex-Utero Support System in Piglets Abrao Trad, Ayssa T Buddington, Randal Enninga, Elizabeth Duncan, Jose Schenone, Claudio V Mari, Giancarlo Buddington, Karyl Schenone, Mauro Cureus Obstetrics/Gynecology Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable patient population. In this study, we report our experience with an ex-utero support system for fetal pigs with the goal of support and survival for eight hours. Our experiment included two pigs at a gestational age equivalent to a 32-week human fetus. Following ultrasound assessment and delivery via hysterotomy, the fetuses were transferred to a 40 L glass aquarium filled with warmed lactated Ringer's solution and connected to an arteriovenous (AV) circuit that included a centrifugal pump and a pediatric oxygenator. Fetus 1 was successfully cannulated and survived for seven hours (expected maximum duration of eight hours). Fetus 2 died shortly after hysterotomy, secondary to failure at the cannulation stage. Our results suggest that ex-utero support of the premature fetal pig is feasible, contributing to a scarce body of evidence. However, further studies are needed before effectively translating an artificial placenta system into the clinical arena. Cureus 2023-04-27 /pmc/articles/PMC10224797/ /pubmed/37252594 http://dx.doi.org/10.7759/cureus.38223 Text en Copyright © 2023, Abrao Trad et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Obstetrics/Gynecology
Abrao Trad, Ayssa T
Buddington, Randal
Enninga, Elizabeth
Duncan, Jose
Schenone, Claudio V
Mari, Giancarlo
Buddington, Karyl
Schenone, Mauro
Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title_full Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title_fullStr Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title_full_unstemmed Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title_short Report of an Experiment With a Fetal Ex-Utero Support System in Piglets
title_sort report of an experiment with a fetal ex-utero support system in piglets
topic Obstetrics/Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224797/
https://www.ncbi.nlm.nih.gov/pubmed/37252594
http://dx.doi.org/10.7759/cureus.38223
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