Neurologic outcomes of the premature lamb in an extrauterine environment for neonatal development.

Autor: McGovern PE; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Hornick MA; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Mejaddam AY; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Lawrence K; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Schupper AJ; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Rossidis AC; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Baumgarten H; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Vossough A; Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Didier RA; Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Kim A; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Partridge EA; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Hwang G; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Young K; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Peranteau WH; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Davey MG; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA., Flake AW; The Center for Fetal Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: flake@email.chop.edu.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2020 Oct; Vol. 55 (10), pp. 2115-2123. Date of Electronic Publication: 2020 Jan 08.
DOI: 10.1016/j.jpedsurg.2019.12.026
Abstrakt: Background/purpose: Neurologic injury remains the most important morbidity of prematurity. Those born at the earliest gestational ages can face a lifetime of major disability. Perinatal insults result in developmental delay, cerebral palsy, and other profound permanent neurologic impairments. The EXTracorporeal Environment for Neonatal Development (EXTEND) aims to transition premature neonates through this sensitive period, but it's impact on neurologic development requires analysis.
Methods: Fetal sheep were maintained in a fluid-filled environment for up to 28 days. Physiologic parameters were measured continuously; tissues were subsequently fixed and preserved for myelin quantification, glial cell staining, and structural assessment via magnetic resonance. Surviving animals were functionally assessed.
Results: No evidence of fetal brain ischemia or white matter tract injury associated with the EXTEND system was detected, and the degree of myelination was regionally appropriate and consistent with age matched controls. No evidence of neurologic injury or immaturity was visible on magnetic resonance; animals that transitioned from the system had no persistent neurologic deficits.
Conclusions: No evidence of major neurologic morbidity was found in animals supported on the EXTEND system, though more work needs to be done in order to verify its safety during critical periods of neurologic development.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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