Quote from babyNP.
If you read the original article in Nature they actually don't use much heparin at all compared to traditional ECMO and hope to use none in the future. They also don't have a flow rate- it's all passive so as not to overload the heart and go through the umbilical vessels.
So mimicking the passive circulation that the fetus experiences in utero? The biomechanics of how that would actually work are way over my head, but it's an awesome concept.
Quote from babyNP.
You can talk about guinea pigs...but that's how most things in neonatology get started, like the first runs of ECMO. Of course, the USA actually let the UK run the trials first and decided to do it based off of their results. I suppose if they can offer a better survival rate and better morbidity rate to parents than a traditional 22 or 23 weeker, then your benefits would outweigh the risks. Just imagine if we could grow these babies to 28 weeks- the drastically reduced mortality/morbidity rate effects would be phenomenal.
I was thinking the same thing. I'm sure that 'back in the day' when our viability cut-off was much later and our current technologies were first being debuted, people probably had similar concerns. I agree that if it works, the benefits could be immense, since we wouldn't really have as many '23-weekers' anymore, as they could be grown to be more like '28-weekers'.
Still lots of ethical concerns/considerations. Like I said in my first post, I doubt that many parents will consent unless that is their only option, and it would be pretty terrible if the human trials failed catastrophically.
Quote from Guy in Babyland
How would this logistically work in humans? Woman goes into preterm labor at 24 weeks, they do a C section and transfer the fetus to the BioBag?
I was curious to know if there would be any concerns about fetal/neonatal transition occurring during the 'uterus to bag' transfer process. It seems like you'd want to keep PVR high and SVR low in the bag circuit, as in utero, and you could run into issues if the baby began to transition during the transfer. Presumably they figured out a way to get past that barrier in the fetal lamb model, but it does seem like it would present a potential challenge. I know it's possible to keep PDAs open, and for kids to be in PPHN (unintentionally), but is it even possible to medically induce a baby who is in neonatal circulation to revert back to fetal?