The artificial placenta: Continued lung development during extracorporeal support in a preterm lamb model
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Jun 2018 · 1 min read
In brief
In brief
Experimental study demonstrates that preterm lambs supported on an artificial placenta system using venovenous ECLS with fluid-filled lungs showed continued alveolar development over 10 days, with better lung compliance and less injury compared to mechanically ventilated controls at equivalent gestational ages.
Written by the GCMD Library team from the article.
Purpose
An artificial placenta (AP) utilizing extracorporeal life support (ECLS) could avoid the harm of mechanical ventilation (MV) while allowing the lungs to develop.
Methods
AP lambs (n = 5) were delivered at 118 days gestational age (GA; term = 145 days) and placed on venovenous ECLS (VV-ECLS) with jugular drainage and umbilical vein reinfusion. Lungs remained fluid-filled. After 10 days, lambs were ventilated. MV control lambs were delivered at 118 ("early MV"; n = 5) or 128 days ("late MV"; n = 5), and ventilated. Compliance and oxygenation index (OI) were calculated. After sacrifice, lungs were procured and H&E-stained slides scored for lung injury. Slides were also immunostained for PDGFR-α and α-actin; alveolar development was quantified by the area fraction of alveolar septal tips staining double-positive for both markers.
Results
Compliance of AP lambs was 2.79 ± 0.81 Cdyn compared to 0.83 ± 0.19 and 3.04 ± 0.99 for early and late MV, respectively. OI in AP lambs was lower than early MV lambs (6.20 ± 2.10 vs. 36.8 ± 16.8) and lung injury lower as well (1.8 ± 1.6 vs. 6.0 ± 1.2). Double-positive area fractions were higher in AP lambs (0.012 ± 0.003) than early (0.003 ± 0.0005) and late (0.004 ± 0.002) MV controls.
Conclusions
Lung development continues and lungs are protected from injury during AP support relative to mechanical ventilation.
Level of evidence
n/a (basic/translational science).