Experimental Study for Extrauterine Incubation and Breathing of Fetal Lambs

【材料与方法】对照组胎羊（N=6）：胎羊于妊娠125-140 d，采用经颈部血管V-A ECMO，在人工羊水罐中培养。孵育6- 24小时后，诱导肺呼吸开始，并尝试从系统中脱机。膈疝模型（N=6）：在妊娠75-80天之间创建膈疝，并在妊娠135天在子宫内修复以支持V-A ECMO。这些胎羊的孵育（6- 24小时）和从系统中断奶与对照胎羊相同。在孵化和脱离系统期间。监测心电图、血压、中心静脉压，并进行血气分析和多普勒超声检查。[结果] 1.胎儿的循环状况在整个孵育过程中保持稳定，不受PDA流量变化的影响。2.超过135个妊娠日的对照胎仔能够在呼吸后脱离孵育系统。3.在V-A ECMO的支持下，膈疝可以在子宫内安全修复。[结论]建立了经宫颈血管V-A ECMO子宫外胎儿孵育系统。胎羊能保持稳定的生理状态，疝修补术安全可靠。这项研究的结果表明，在未来，一个胎儿与严重的肺发育不良可能能够生存的支持下，这一系统。

[Material and Method] Control Fetal lambs (N=6) : Using a V-A ECMO via cervical vessels, fetal lambs were incubated in an artificial amnionic fluid tank at 125-140 gestational days. After Incubation for 6-24hrs, an initiation of lung respiration was induced and weaning from the sytem was attempted. Diaphragmatic Hernia Model (N=6) : Diaphragmatic hernia was created between 75-80 gestational days and repaired in uterus in support of V-A ECMO at 135 gestational days. incubation of these fetal lambs (6-24h) and weaning from the system were done as same as controle fetal lambs. During incubation and weaning from the system. ECG,BP and CVP were monitered and blood gas alnalysis and doppler sonographic examination were performed.[Result] 1. The circulatory condition of fetuses maintained stable throughout the incubation not influenced by change of PDA flow. 2. Control fetuses over 135 gestational days were able to wean from the incubation system after breathing. 3. Diaphragmatic hernia could be repaired safely in utero in support of the V-A ECMO.[Conclusion] We developed an extrauterin fetal incubation system using V-A ECMO via cervical vessels. The fetal lambs could be kept under stable physiological conditions and diaphragmatic hernia was safely repaired with this system. The result of this study suggest that in future, a fetus with severe pulmonary hypoplasia may be able to survive supported by this system.