Development of an Artificial Placenta

人工胎盘的开发

• 批准号: 7773104
• 负责人: George Boris Mychaliska
• 金额: $ 7.56万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7773104
• 关键词: Address; Animal Model; Animals; Attention; Birth; Blood Circulation; Blood Vessels; Caring; Data; Development; Environment; Gases; Goals; Health; Hour; Immune; Infant; Laboratories; Life; Maintenance; Mechanical ventilation; Mechanics; Modeling; Morbidity - disease rate; Neuraxis; Newborn Infant; Phase; Placenta; Pregnancy; Premature Birth; Premature Infant; Pump; Research; Research Personnel; Resources; Respiratory Failure; Sheep; Techniques; Technology; United States; Venous; conventional therapy; cost; effective therapy; experience; fetal; gastrointestinal; hemodynamics; mortality; novel; premature; prototype; public health relevance; research study; respiratory; treatment strategy

DESCRIPTION (provided by applicant): There are 5 million births in the United States each year of which 500,000 are premature. Premature delivery is associated with substantial mortality, morbidity and escalating cost. The complications of premature birth result in substantial respiratory, gastrointestinal, immune and central nervous system morbidity and significant mortality. In particular, effective treatment of respiratory failure in premature infants remains an unsolved problem. Several strategies have been developed to support these infants, including refinements in mechanical ventilation and the use of extracorporeal life support (ECLS) in severe respiratory failure. ECLS is limited to infants >34 weeks gestation for 2-3 weeks, requires systemic heparinization and does not maintain fetal circulation. To circumvent many of these challenges, the development of an artificial placenta in the form of a pump-driven arterio-venous AV-ECLS circuit with access via the umbilical vessels is an appealing alternative. For the last 40 years, many investigators have tried to make an artificial placenta but it has never gone beyond the concept phase because of limited technology. Our laboratory has developed a maternal-fetal sheep model with preliminary data demonstrating the feasibility to address this problem. We aim to further characterize and develop this model to prepare for longer duration experiments. We realize that this is a long term project which will impact substantially upon the care of premature newborns. The goal of this proposal is to develop an animal model in the preterm fetal lamb with full extracorporeal gas exchange via the umbilical vessels and maintenance of hemodynamic stability and normal fetal circulation. The specific aims of this proposal are 1) to develop a prototype arterio-venous ECLS artificial placenta including umbilical vessel access and the techniques necessary to provide fetal support; and 2) to maintain stable fetal circulation during AV- ECLS for 24 hours, with particular attention to identify those factors which will limit practical long-term application. PUBLIC HEALTH RELEVANCE: The complications associated with premature birth remain a major unsolved health problem. We propose development of a mechanical artificial placenta that would allow a premature infant to grow and thrive while avoiding the many complications using conventional treatment. Development of an artificial placenta would revolutionize the care of premature infants.

描述（由申请人提供）：美国每年有500万个出生，其中500,000个为时过早。过早的交付与大量死亡率，发病率和升级成本有关。过早出生的并发症导致大量呼吸，胃肠道，免疫和中枢神经系统发病率以及显着的死亡率。特别是，早产婴儿中呼吸衰竭的有效治疗仍然是一个未解决的问题。已经制定了几种支持这些婴儿的策略，包括在严重呼吸衰竭中使用机械通气的改进以及使用体外生命支持（ECLS）。 ECLS仅限于婴儿> 34周妊娠2-3周，需要全身性肝素化，并且不维持胎儿循环。为了应对许多挑战，以泵驱动的动脉驱动的AV-ECLS电路的形式开发人造胎盘，可以通过脐带访问脐带，这是一种吸引人的选择。在过去的40年中，许多调查人员试图制作人造胎盘，但由于技术有限，它从未超越概念阶段。我们的实验室已经开发了一种母亲绵羊模型，并具有初步数据，证明了解决此问题的可行性。我们的目标是进一步表征和开发该模型，以准备更长的持续时间实验。我们意识到，这是一个长期项目，将对早产新生儿的照顾产生重大影响。该提案的目的是通过脐带血管中的早产胎儿羔羊开发动物模型，并维持血液动力学稳定性和正常胎儿循环。该提案的具体目的是1）开发一种原型动脉ecls人造胎盘，包括脐带容器，以及提供胎儿支撑所需的技术； 2）在24小时内保持稳定的胎儿循环，特别注意这些因素会限制实际的长期应用。 公共卫生相关性：与早产相关的并发症仍然是一个主要的未解决的健康问题。我们建议开发机械人造的胎盘胎，该胎盘胎胎将使早产儿生长和繁殖，同时避免使用常规治疗的许多并发症。人造胎盘的发展将彻底改变对早产儿的护理。