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Deprecated: Implicit conversion from float 215.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Curr+Opin+Pediatr 2014 ; 26 (3): 370-6 Nephropedia Template TP
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A Paradigm Shift in the Treatment of Extreme Prematurity: The Artificial Placenta #MMPMID24786370
Davis RP; Benjamin B
Curr Opin Pediatr 2014[Jun]; 26 (3): 370-6 PMID24786370show ga
Purpose of Review: Extremely low gestational age newborns (ELGANs), born at <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 (AP) 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 AP, the purported benefits, and the most recent research efforts in this area. Recent Findings: For fifty years, researchers have attempted to develop an AP based on ECLS. Traditional AP strategies have been based on arteriovenous ECLS (AV-ECLS) using the umbilical vessels with moderate success. Recently, the use of venovenous ECLS (VV-ECLS) and miniaturization of ECLS components have shown potential for creating a next-generation AP. Summary: ELGANs suffer the greatest morbidity and mortality of prematurity, and are poised to benefit from a paradigm shift in treatment. While challenges remain, the AP is feasible. An AP would not only protect ELGANs from the complications of mechanical ventilation, but support their development until a stage of greater maturity, preparing them for a life free of the sequelae of prematurity.