Extracorporeal fetal support: A new animal model with preservation of the placenta

Jose H. Salazar, Alodia Gabre-Kidan, Gezzer Ortega, Diana Scorpio, Gary Oldenburg, Haven Custis, Dawn Ruben, Melanie Albano, Shelly S. Choo, Daniel S. Rhee, William B. Fulton, Qihong Wang, Dominic Papandria, Jude P. Crino, Fizan Abdullah

Research output: Contribution to journalArticle

Abstract

Background Previous models of support for premature sheep fetuses have consisted of cesarean delivery followed by catheterization of umbilical or central vessels and support with extracorporeal membrane oxygenation (ECMO). The limitations of these models have been insufficient blood flow, significant fetal edema, and hemorrhage related to anticoagulation.

Methods We performed a gravid hysterectomy on 13 ewes between 135 and 145 days gestational age. The uterine vessels were cannulated bilaterally and circulatory support was provided via ECMO. Successful transition was defined as maintenance of fetal heart rate for 30 minutes after establishing full extracorporeal support. Circuit flow was titrated to maintain mixed venous oxygen saturation (SvO2) of 70-75%.

Results Seven experiments were successfully transitioned to ECMO, with an average survival time of 2 hours 9 minutes. The longest recorded time from cannulation to death was 6 hours 14 minutes. By delivering a circuit flow of up to 2120 ml/min, all but one of the transitioned uteri were maintained within the desired SvO2 range.

Conclusion We report a novel animal model of fetal ECMO support that preserves the placenta, mitigates the effects of heparin, and allows for increased circuit flow compared to prior techniques. This approach may provide insight into a technique for future studies of fetal physiology.

Original languageEnglish (US)
Pages (from-to)1441-1445
Number of pages5
JournalJournal of pediatric surgery
Volume49
Issue number10
DOIs
StatePublished - Oct 1 2014

Keywords

  • Artificial placenta
  • ECMO
  • Fetal support
  • Fetus
  • Sheep
  • words

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Salazar, J. H., Gabre-Kidan, A., Ortega, G., Scorpio, D., Oldenburg, G., Custis, H., Ruben, D., Albano, M., Choo, S. S., Rhee, D. S., Fulton, W. B., Wang, Q., Papandria, D., Crino, J. P., & Abdullah, F. (2014). Extracorporeal fetal support: A new animal model with preservation of the placenta. Journal of pediatric surgery, 49(10), 1441-1445. https://doi.org/10.1016/j.jpedsurg.2014.05.028