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

Ryan P. Davis, Benjamin Bryner, George B. Mychaliska*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)370-376
Number of pages7
JournalCurrent opinion in pediatrics
Volume26
Issue number3
DOIs
StatePublished - Jun 2014

Keywords

  • Artificial placenta
  • ECLS
  • ECMO
  • ELGANs
  • prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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