TY - JOUR
T1 - Effects of an artificial placenta on brain development and injury in premature lambs
AU - Church, Joseph T.
AU - Werner, Nicole L.
AU - Coughlin, Meghan A.
AU - Menzel-Smith, Julia
AU - Najjar, Mary
AU - Carr, Benjamin D.
AU - Parmar, Hemant
AU - Neil, Jeff
AU - Alexopoulos, Dimitrios
AU - Perez-Torres, Carlos
AU - Ge, Xia
AU - Beeman, Scott C.
AU - Garbow, Joel R.
AU - Mychaliska, George B.
N1 - Funding Information:
The research presented in this manuscript was supported by the National Institutes of Health NIH grants R01 HD073475 and P30 HD062171.
Funding Information:
The research presented in this manuscript was supported by the National Institutes of Health NIH grants R01 HD073475 and P30 HD062171 .
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/6
Y1 - 2018/6
N2 - Purpose: We evaluated whether brain development continues and brain injury is prevented during Artificial Placenta (AP) support utilizing extracorporeal life support (ECLS). Methods: Lambs at EGA 118 days (term = 145; n = 4) were placed on AP support (venovenous ECLS with jugular drainage and umbilical vein reinfusion) for 7 days and sacrificed. Early (EGA 118; n = 4) and late (EGA 127; n = 4) mechanical ventilation (MV) lambs underwent conventional MV for up to 48 h and were sacrificed, and early (n = 5) and late (n = 5) tissue control (TC) lambs were sacrificed at delivery. Brains were harvested, formalin-fixed, rehydrated, and studied by magnetic resonance imaging (MRI). The gyrification index (GI), a measure of cerebral folding complexity, was calculated for each brain. Diffusion-weighted imaging was used to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in multiple structures to assess white matter (WM) integrity. Results: No intracranial hemorrhage was observed. GI was similar between AP and TC groups. ADC and FA did not differ between AP and late TC groups in any structure. Compared to late MV brains, AP brains demonstrated significantly higher ADC (0.45 ± 0.08 vs. 0.27 ± 0.11, p = 0.02) and FA (0.61 ± 0.04 vs. 0.44 ± 0.05; p = 0.006) in the cerebral peduncles. Conclusions: After 7 days of AP support, WM integrity is preserved relative to mechanical ventilation. Type of study: Research study.
AB - Purpose: We evaluated whether brain development continues and brain injury is prevented during Artificial Placenta (AP) support utilizing extracorporeal life support (ECLS). Methods: Lambs at EGA 118 days (term = 145; n = 4) were placed on AP support (venovenous ECLS with jugular drainage and umbilical vein reinfusion) for 7 days and sacrificed. Early (EGA 118; n = 4) and late (EGA 127; n = 4) mechanical ventilation (MV) lambs underwent conventional MV for up to 48 h and were sacrificed, and early (n = 5) and late (n = 5) tissue control (TC) lambs were sacrificed at delivery. Brains were harvested, formalin-fixed, rehydrated, and studied by magnetic resonance imaging (MRI). The gyrification index (GI), a measure of cerebral folding complexity, was calculated for each brain. Diffusion-weighted imaging was used to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in multiple structures to assess white matter (WM) integrity. Results: No intracranial hemorrhage was observed. GI was similar between AP and TC groups. ADC and FA did not differ between AP and late TC groups in any structure. Compared to late MV brains, AP brains demonstrated significantly higher ADC (0.45 ± 0.08 vs. 0.27 ± 0.11, p = 0.02) and FA (0.61 ± 0.04 vs. 0.44 ± 0.05; p = 0.006) in the cerebral peduncles. Conclusions: After 7 days of AP support, WM integrity is preserved relative to mechanical ventilation. Type of study: Research study.
KW - Artificial placenta
KW - Brain development
KW - Extracorporeal life support
KW - Prematurity
KW - White matter injury
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U2 - 10.1016/j.jpedsurg.2018.02.091
DO - 10.1016/j.jpedsurg.2018.02.091
M3 - Article
C2 - 29605267
AN - SCOPUS:85044515412
SN - 0022-3468
VL - 53
SP - 1234
EP - 1239
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 6
ER -