Frontiers in Physiology (Jul 2022)
Impact of the Addition of a Centrifugal Pump in a Preterm Miniature Pig Model of the Artificial Placenta
- Alex J. Charest-Pekeski,
- Alex J. Charest-Pekeski,
- Steven K. S. Cho,
- Steven K. S. Cho,
- Steven K. S. Cho,
- Tanroop Aujla,
- Tanroop Aujla,
- Liqun Sun,
- Alejandro A. Floh,
- Alejandro A. Floh,
- Mark J. McVey,
- Mark J. McVey,
- Mark J. McVey,
- Ayman Sheta,
- Marvin Estrada,
- Lynn Crawford-Lean,
- Celeste Foreman,
- Dariusz Mroczek,
- Jaques Belik,
- Brahmdeep S. Saini,
- Brahmdeep S. Saini,
- Jessie Mei Lim,
- Jessie Mei Lim,
- Olivia J. Moir,
- Olivia J. Moir,
- Fu-Tsuen Lee,
- Fu-Tsuen Lee,
- Megan Quinn,
- Jack R. T. Darby,
- Mike Seed,
- Mike Seed,
- Mike Seed,
- Janna L. Morrison,
- Janna L. Morrison,
- Janna L. Morrison,
- Christoph Haller
Affiliations
- Alex J. Charest-Pekeski
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Alex J. Charest-Pekeski
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Steven K. S. Cho
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Steven K. S. Cho
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Steven K. S. Cho
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Tanroop Aujla
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Tanroop Aujla
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Liqun Sun
- Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Alejandro A. Floh
- Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Alejandro A. Floh
- Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Mark J. McVey
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Mark J. McVey
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Mark J. McVey
- Department of Physics, Ryerson University, Toronto, ON, Canada
- Ayman Sheta
- Department of Pediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
- Marvin Estrada
- Lab Animal Services, Peter Gilgan Center for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
- Lynn Crawford-Lean
- 0Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Celeste Foreman
- 0Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- Dariusz Mroczek
- Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Jaques Belik
- Department of Pediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada
- Brahmdeep S. Saini
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Brahmdeep S. Saini
- 1Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Jessie Mei Lim
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Jessie Mei Lim
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Olivia J. Moir
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Olivia J. Moir
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Fu-Tsuen Lee
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Fu-Tsuen Lee
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Megan Quinn
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Jack R. T. Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Mike Seed
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Mike Seed
- Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Mike Seed
- 1Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Janna L. Morrison
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Janna L. Morrison
- Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Janna L. Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Christoph Haller
- 0Division of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
- DOI
- https://doi.org/10.3389/fphys.2022.925772
- Journal volume & issue
-
Vol. 13
Abstract
The recent demonstration of normal development of preterm sheep in an artificial extrauterine environment has renewed interest in artificial placenta (AP) systems as a potential treatment strategy for extremely preterm human infants. However, the feasibility of translating this technology to the human preterm infant remains unknown. Here we report the support of 13 preterm fetal pigs delivered at 102 ± 4 days (d) gestation, weighing 616 ± 139 g with a circuit consisting of an oxygenator and a centrifugal pump, comparing these results with our previously reported pumpless circuit (n = 12; 98 ± 4 days; 743 ± 350 g). The umbilical vessels were cannulated, and fetuses were supported for 46.4 ± 46.8 h using the pumped AP versus 11 ± 13 h on the pumpless AP circuit. Upon initiation of AP support on the pumped system, we observed supraphysiologic circuit flows, tachycardia, and hypertension, while animals maintained on a pumpless AP circuit exhibited subphysiologic flows. On the pumped AP circuit, there was a progressive decline in umbilical vein (UV) flow and oxygen delivery. We conclude that the addition of a centrifugal pump to the AP circuit improves survival of preterm pigs by augmenting UV flow through the reduction of right ventricular afterload. However, we continued to observe the development of heart failure within a matter of days.
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