title: NeonatOx: a pumpless extracorporeal lung support for premature neonates.
abstract: Gas exchange in premature neonates is regularly impaired by structural and functional immaturity of the lung. Mechanical ventilation, which is vitally important to sustain oxygenation and CO(2)  elimination, causes, at the same time, mechanical and inflammatory destruction of lung tissue. To date, extracorporeal oxygenation is not a treatment option, one reason among others being the size of available oxygenators and cannulas. We hypothesized that a substantial improvement in gas exchange can be achieved by maintenance of the fetal cardiopulmonary bypass and interposition of a suitable passively driven (arteriovenous) membrane oxygenator. In close cooperation between engineers and neonatologists, we developed a miniaturized oxygenator and adapted cannulas to be used as a pumpless extracorporeal lung support that is connected to the circulation via cannulation of the umbilical cord vessels. First in vitro and in vivo studies show promising results. We regard this as one step on the way to clinical application of the artificial placenta.
authors: Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany. jutta.arens@act8.de
authors: Jutta
authors: J
authors: Arens
authors: Mark
authors: M
authors: Schoberer
authors: Anne
authors: A
authors: Lohr
authors: Thorsten
authors: T
authors: Orlikowsky
authors: Matthias
authors: M
authors: Seehase
authors: Reint K
authors: RK
authors: Jellema
authors: Jennifer J
authors: JJ
authors: Collins
authors: Boris W
authors: BW
authors: Kramer
authors: Thomas
authors: T
authors: Schmitz-Rode
authors: Ulrich
authors: U
authors: Steinseifer
mesh_terms: D000818:Animals; D002248:Carbon Monoxide / Q000378:metabolism; D002404:Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000502:physiology*; D008297:Male; D010100:Oxygen / Q000378:metabolism; D010106:Oxygenators; D011897:Random Allocation; D012756:Sheep; D014470:Umbilical Cord / Q000098:blood supply*
chemical_list: D002248:Carbon Monoxide; D010100:Oxygen