دورية أكاديمية

The role of fetal hemoglobin in the artificial placenta: A premature ovine model

التفاصيل البيبلوغرافية
العنوان: The role of fetal hemoglobin in the artificial placenta: A premature ovine model
المؤلفون: Spencer, Brianna L, Fallon, Brian P, McLeod, Jennifer S, Cornell, Marie, Perrone, Erin E, Manthei, David M, Rojas-Peña, Alvaro, Hirschl, Ronald B, Bartlett, Robert H, Mychaliska, George B
المساهمون: National Institutes of Health
المصدر: Perfusion ; ISSN 0267-6591 1477-111X
بيانات النشر: SAGE Publications
سنة النشر: 2024
مصطلحات موضوعية: Advanced and Specialized Nursing, Cardiology and Cardiovascular Medicine, Safety Research, Radiology, Nuclear Medicine and imaging, General Medicine
الوصف: Introduction A radical paradigm shift in the treatment of premature infants failing conventional treatment is to recreate fetal physiology using an extracorporeal Artificial Placenta (AP). The aim of this study is to evaluate the effects of changing fetal hemoglobin percent (HbF%) on physiology and circuit function during AP support in an ovine model. Methods Extremely premature lambs ( n = 5) were delivered by cesarean section at 117-121 d estimated gestational age (EGA) (term = 145d), weighing 2.5 ± 0.35 kg. Lambs were cannulated using 10-14Fr cannulae for drainage via the right jugular vein and reinfusion via the umbilical vein. Lambs were intubated and lungs were filled with perfluorodecalin to a meniscus with a pressure of 5–8 cm H 2 O. The first option for transfusion was fetal whole blood from twins followed by maternal red blood cells. Arterial blood gases were used to titrate AP support to maintain fetal blood gas values. Results The mean survival time on circuit was 119.6 ± 39.5 h. Hemodynamic parameters and lactate were stable throughout. As more adult blood transfusions were given to maintain hemoglobin at 10 mg/dL, the HbF% declined, reaching 40% by post operative day 7. The HbF% was inversely proportional to flow rates as higher flows were required to maintain adequate oxygen saturation and perfusion. Conclusions Transfusion of adult blood led to decreased fetal hemoglobin concentration during AP support. The HbF% was inversely proportional to flow rates. Future directions include strategies to decrease the priming volume and establishing a fetal blood bank to have blood rich in HbF.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1177/02676591241240725
الإتاحة: https://doi.org/10.1177/02676591241240725Test
حقوق: https://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest
رقم الانضمام: edsbas.EEBC73D5
قاعدة البيانات: BASE