Volume 36, Issue 6 pp. 512-516

Fifty Years of Work on the Artificial Placenta: Milestones in the History of Extracorporeal Support of the Premature Newborn

Mark Schoberer

Corresponding Author

Mark Schoberer

Neonatology Section of the Department of Paediatric and Adolescent Medicine, University Hospital, RWTH Aachen University

Dr. Mark Schoberer, Neonatology Section of the Department of Paediatric and Adolescent Medicine, University Hospital, RWTH Aachen University, Pauwelsstr. 30, Aachen, 52074, Germany. E-mail: [email protected]Search for more papers by this author
Jutta Arens

Jutta Arens

Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany

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Anne Lohr

Anne Lohr

Neonatology Section of the Department of Paediatric and Adolescent Medicine, University Hospital, RWTH Aachen University

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Matthias Seehase

Matthias Seehase

Department of Paediatrics, School of Mental Health and Neuroscience; School of Oncology and Developmental Biology; Maastricht University Medical Center, Maastricht, The Netherlands

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Reint K. Jellema

Reint K. Jellema

Department of Paediatrics, School of Mental Health and Neuroscience; School of Oncology and Developmental Biology; Maastricht University Medical Center, Maastricht, The Netherlands

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Jennifer J. Collins

Jennifer J. Collins

Department of Paediatrics, School of Mental Health and Neuroscience; School of Oncology and Developmental Biology; Maastricht University Medical Center, Maastricht, The Netherlands

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Boris W. Kramer

Boris W. Kramer

Department of Paediatrics, School of Mental Health and Neuroscience; School of Oncology and Developmental Biology; Maastricht University Medical Center, Maastricht, The Netherlands

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Thomas Schmitz-Rode

Thomas Schmitz-Rode

Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany

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Ulrich Steinseifer

Ulrich Steinseifer

Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany

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Thorsten Orlikowsky

Thorsten Orlikowsky

Neonatology Section of the Department of Paediatric and Adolescent Medicine, University Hospital, RWTH Aachen University

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First published: 06 February 2012
Citations: 26

First two authors contributed equally to this manuscript.

Presented in part at the 7th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion held May 5–7, 2011 in Philadelphia, PA, USA.

Abstract

The concept of an artificial placenta has been pursued in experimental research since the early 1960s. The principle has yet to be successfully implemented in neonatal care despite the constant evolution in extracorporeal life support technology and advancements in neonatal intensive care in general. For more than three decades, the physical dimensions of the required equipment necessitated pump-driven circuits; however, recent advances in oxygenator technology have allowed exploration of the simpler and physiologically preferable concept of pumpless arteriovenous oxygenation. We expect that further miniaturization of the extracorporeal circuit will allow the implementation of the concept into clinical application as an assist device. To this end, NeonatOx (Fig. 1), a custom-made miniaturized oxygenator with a filling volume of 20 mL, designed by our own group, has been successfully implemented with a preterm lamb model of less than 2000 g body weight as an assist device. We provide an overview of milestones in the history of extracorporeal membrane oxygenation of the preterm newborn juxtaposed against current and future technological advancements. Key limitations, which need to be addressed in order to make mechanical gas exchange a clinical treatment option of prematurity-related lung failure, are also identified.

Details are in the caption following the image

NeonatOx, a low-volume extracorporeal assist device for preterm lung failure.

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