ECLS for preemies: The artificial placenta

The high mortality and morbidity associated with respiratory failure among extremely low gestational age newborns (ELGANs) remains an unsolved problem. A logical strategy to avoid these complications would involve re-creating the intrauterine environment with extracorporeal membrane oxygenation (ECMO) instead of mechanical ventilation. Such a device, termed an artificial placenta, was first researched over 50 years ago. AP models vary, but all incorporate ECMO involving the umbilical vessels, lack of mechanical ventilation, and low partial pressure of oxygen to preserve fetal circulation. Current research has focused on low-volume pumpless arteriovenous circuits as well as pump-driven venovenous circuits. (C) 2014 Elsevier Inc. All rights reserved.