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NeonatOx – A Pumpless Extracorporeal Lung Support for Premature Neonates

Gas exchange in premature neonates is regularly impaired by structural and functional immaturitiy of the lung. Mechanical ventilation, which is vitally important to sustain oxygenation and CO2-elimination causes at the same time mechanical and inflammatory destruction of lung tissue. To date extracorporeal oxygenation is no treatment option, one reason among others being the size of available oxygenators and cannulas.

We hypothesized that, by maintenance of the fetal cardiopulmonary bypass and interposition of a suitable passively (arterio-venous) driven membrane oxygenator, a substantial improvement in gas exchange can be achieved. In close cooperation between our engineers and the neonatologists of the Section Neonatology (Department of Paediatric and Adolescent Medicine at the University Hospital Aachen) we developed a miniaturized oxygenator and adapted cannulas both to be used as a pumpless extracorporeal lung support which is connected to the circulation via cannulation of the umbilical cord vessels (in the sense of an “artificial placenta”).

This oxygenator (NeonatOx, fig. 1) with 0.09 m² gas exchange surface area and 12 ml priming volume (19 ml incl. tubing) was designed, produced and tested in vitro and invivo. In vitro tests showed a typical gas exchange of 47 mlCO2/lblood and 53 mlO2/lblood at 80 ml/min blood flow and 160 ml oxygen flow.

Further steps of the project will be an optimization of the extracorporeal circuit and the cannulas.

We like to thank Matthias Seehase, MD, Reint K. Jellema, MD, Jennifer J. Collins, and Prof. Boris W. Kramer, MD, PhD of the Department of Experimental Perinatology
(Department of Paediatrics, Maastricht University Medical Center, Maastricht, The Netherlands) for their professional assistance.

Fig. 1: NeonatOx in working process

Publications

  • Schoberer M, Arens J, Erben A, Ophelders D, Jellema RK, Kramer BW, Bruse JL, De Brouwer P, Schmitz-Rode T, Steinseifer U, Orlikowsky T: Minaturization: The Clue to Clinical Application of the Artificial Placenta. Artif Organs. 38(3):208–214, 2014
  • Schoberer M, Arens J, Lohr A, Seehase M, Jellema RK, Collins JJ, Kramer BW, Schmitz-Rode T, Steinseifer U, and Orlikowsky T: Fifty years of work on the artificial placenta: Milestones in the history of extracorporeal support of the premature newborn. Artif Organs, 36(6):512–516, 2012
  • Arens J, Schoberer M, Lohr A, Orlikowsky T, Seehase M, Jellema RK, Collins JJ, Kramer BW, Schmitz-Rode T, Steinseifer U: NeonatOx - A Pumpless Extracorporeal Lung Support for Premature Neonates. Artificial Organs. 35(11):997–1001, 2011

Abstracts

  • Arens J, Schoberer M, Erben A, Orlikowsky T, Ophelders D, Jellema RK, Kramer BW, De Brouwer P, Schmitz-Rode T, Steinseifer U: Neonatox: A Pumpless Extracorporeal Lung Support for Premature Infants. ASAIO J, 58(7):48, 2012
  • Arens J, Schoberer M, Erben A, Orlikowsky T, Ophelders D, Jellema RK, Kramer BW, De Brouwer P, Schmitz-Rode T, Steinseifer U: The NeonatOx: An Update on Design, In-Vitro, and In-Vivo Testing. Artif Organs, 36(5):A23, 2012
  • Schoberer M, Arens J, Erben A, Ophelders D, Jellema RK, Kramer BW, De Brouwer P, Schmitz-Rode T, Steinseifer U, Orlikowsky T: Miniaturisation: The Clue to Clinical Application of the Artificial Placenta. Artif Organs, 36(5):A24, 2012
  • Arens J, Schoberer M, Lohr A, Orlikowsky T, Seehase M, Jellema RK, Collins JJ, Kramer BW, Schmitz-Rode T, Steinseifer U: A Pumpless Extracorporeal Lung Assist for Premature Neonates: The Aachen Neonatox. Int J Artif Organs. 34(8):670, 2011
  • Arens J, Schoberer M, Lohr A, Orlikowsky T, Seehase M, Jellema RK, Collins JJ, Kramer BW, Schmitz-Rode T, Steinseifer U: NeonatOx - A Pumpless Extracorporeal Lung Support for Premature Neonates. Artificial Organs. 35(4):A8, 2011
  • Schoberer M, Arens J, Lohr A, Seehase M, Jellema RK, Collins JJ, Kramer BW, Schmitz-Rode T, Steinseifer U, Orlikowsky T: 50 Years of Research on the Artificial Placenta: Can we turn a Toy into a Treasure? Artificial Organs. 35(4):A9, 2011

Contact

Dr.-Ing. Jutta Arens

Phone: +49 241 80 87018

E-mail

 

 

This project is sponsored by

 

Project partners

Section Neonatology of the Department of Paediatric and Adolescent Medicine

 

Theses

Find theses in current projects here.