In this edition, we also shine a light on respiratory illnesses, specifically RSV and pertussis, recognising their impact on
neonatal care. Our newly available informational materials and resources aim to equip healthcare professionals with the tools needed for effective patient care.

 

Silke Mader, November 2023
 
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Yearly, around two million neonatal deaths occur worldwide. In many cases, the deaths occur due to fatal lung failure sometimes combined with kidney failure. Together with partners from academia and industry from the Netherlands, Germany, Sweden, Ireland and Canada, TechMed researchers Jutta Arens and Dimitrios Stamatialis aim to develop a novel artificial placenta system, the ArtPlac. To do so, they have been awarded an EIC Pathfinder grant.

 

Gathering international expertise, the ArtPlac consortium came together for a first general assembly meeting to discuss their scientific progress on the development of an ARTificial PLACenta device for preterm and critically ill newborns. While in utero, some of the baby’s vital functions are performed by the placenta, which acts as kidney, as lung, and a way of feeding. Due to the fact that the placenta cannot be reconnected after birth, the ArtPlac project aims to supply an artificial alternative that is less invasive than current state of the art treatments. One central aspect of the new development is to allow a more infant- and family-centred care.

 

Een kunstmatige placenta die wordt ontwikkeld op de Universiteit Twente, moet het leven van honderdduizenden te vroeg geboren baby’s redden. In Enschede wordt het technische deel ontwikkeld van een machine die de sterfte van te jong geborenen met tientallen procenten moet doen kelderen.

 

Gerben Kuitert, March 20, 2023

 

UT scientists Jutta Arens and Dimitrios Stamatialis aredeveloping an artificial placenta, a device that could savelives of hundreds of thousands babies. The technologycombines lung and kidney support for ill newborns and ismuch less invasive than current methods. ‘Our approachwill result in better care for the baby and moreinvolvement of the family. The impact is not only scientific,but also social.

 

Michaela Nesvarova, March 9, 2023

Een kunstmatige placenta die wordt ontwikkeld op de Universiteit Twente, moet het leven van honderdduizenden te vroeg geboren baby’s redden. In Enschede wordt het technische deel ontwikkeld van een machine die de sterfte van te jong geborenen met tientallen procenten moet doen kelderen.

 

Gerben Kuitert, March 20, 2023

 

Catheterization of the umbilical vessels has proven to be an effective and relatively rapid method for gaining central vascular access in neonates. However, it can be technically difficult, the procedure may last 30 min or longer, and it can be associated with complications in some patients. We suggest using a coronary guidewire during catheterization of umbilical vessels to support the placement of umbilical catheters and significantly reduce a risk for complications. We tested the proposed technique in 6 successful ex vivo bench tests of catheterization of the umbilical vessels in stillborn piglets immediately after birth. We are confident that using coronary guidewire as a guiding tool during catheterization of the umbilical vessels is a rapid and safe method. We expect that it allows to obtain a vascular access with lower risk for dangerous procedural complications, which could be a lifesaving in critically ill patients. However, the approach needs to be validated in a comparative study in neonates.

 

Katarzyna Gendera, Stanimir Georgiev, Peter Ewert, Stefan Eckstein, Christoph Fusch, Niels Rochow, 2023

 

Premature neonates suffer from respiratory morbidity as their lungs are immature, and current supportive treatment such as mechanical ventilation or extracorporeal membrane oxygenation causes iatrogenic injuries. A non-invasive and biomimetic concept known as the "artificial placenta" (AP) would be beneficial to overcome complications associated with the current respiratory support of preterm infants. Here, a pumpless oxygenator connected to the systemic circulation supports the lung function to relieve respiratory distress. In this paper, the first successful operation of a microfluidic, artificial placenta type neonatal lung assist device (LAD) on a newborn piglet model, which is the closest representation of preterm human infants, is demonstrated. This LAD has high oxygenation capability in both pure oxygen and room air as the sweep gas. The respiratory distress that the newborn piglet is put under during experimentation, repeatedly and over a significant duration of time, is able to be relieved. These findings indicate that this LAD has a potential application as a biomimetic artificial placenta to support the respiratory needs of preterm neonates.

 

Mohammadhossein Dabaghi, Niels Rochow, Neda Saraei, Gerhard Fusch, Shelley Monkman, Kevin Da, Alireza Shahin-Shamsabadi, John L Brash, Dragos Predescu, Kathleen Delaney, Christoph Fusch, P Ravi Selvaganapathy, 2020

 

Preterm neonates suffering from respiratory distress syndrome require assistive support in the form of mechanical ventilation or extracorporeal membrane oxygenation, which may lead to long-term complications or even death. Here, we describe a high performance artificial placenta type microfluidic oxygenator, termed as a double-sided single oxygenator unit (dsSOU), which combines microwire stainless-steel mesh reinforced gas permeable membranes on both sides of a microchannel network, thereby significantly reducing the diffusional resistance to oxygen uptake as compared to the previous single-sided oxygenator designs. The new oxygenator is designed to be operated in a pumpless manner, perfused solely due to the arterio-venous pressure difference in a neonate and oxygenate blood through exposure directly to ambient atmosphere without any air or oxygen pumping. The best performing dsSOUs showed up to ∼343% improvement in oxygen transfer compared to a single-sided SOU (ssSOU) with the same height. Later, the dsSOUs were optimized and integrated to build a lung assist device (LAD) that could support the oxygenation needs for a 1-2 kg neonate under clinically relevant conditions for the artificial placenta, namely, flow rates ranging from 10 to 60 ml/min and a pressure drop of 10-60 mmHg. The LAD provided an oxygen uptake of 0.78-2.86 ml/min, which corresponded to the increase in oxygen saturation from 57 ± 1% to 93%-100%, under pure oxygen environment. This microfluidic lung assist device combines elegant design with new microfabrication methods to develop a pumpless, microfluidic blood oxygenator that is capable of supporting 30% of the oxygen needs of a pre-term neonate.

 

Mohammadhossein Dabaghi, Gerhard Fusch, Neda Saraei, Niels Rochow, John L Brash, Christoph Fusch, P Ravi Selvaganapathy