Effects of an artificial placenta on brain development and injury in premature lambs
Autor: | Julia Menzel-Smith, Mary Anne Najjar, Hemant Parmar, George B. Mychaliska, Joseph T. Church, Meghan A. Coughlin, Nicole L. Werner, Xia Ge, Carlos J. Perez-Torres, Scott C. Beeman, Dimitrios Alexopoulos, Benjamin D. Carr, Jeffrey J. Neil, Joel R. Garbow |
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Rok vydání: | 2018 |
Předmět: |
Mechanical ventilation
Pathology medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Magnetic resonance imaging General Medicine Article Umbilical vein White matter 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030225 pediatrics Placenta Pediatrics Perinatology and Child Health Fractional anisotropy medicine Effective diffusion coefficient Surgery business Gyrification 030217 neurology & neurosurgery |
Zdroj: | Journal of Pediatric Surgery. 53:1234-1239 |
ISSN: | 0022-3468 |
Popis: | Purpose We evaluated whether brain development continues and brain injury is prevented during Artificial Placenta (AP) support utilizing extracorporeal life support (ECLS). Methods Lambs at EGA 118days (term=145; n=4) were placed on AP support (venovenous ECLS with jugular drainage and umbilical vein reinfusion) for 7days and sacrificed. Early (EGA 118; n=4) and late (EGA 127; n=4) mechanical ventilation (MV) lambs underwent conventional MV for up to 48h and were sacrificed, and early (n=5) and late (n=5) tissue control (TC) lambs were sacrificed at delivery. Brains were harvested, formalin-fixed, rehydrated, and studied by magnetic resonance imaging (MRI). The gyrification index (GI), a measure of cerebral folding complexity, was calculated for each brain. Diffusion-weighted imaging was used to determine fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in multiple structures to assess white matter (WM) integrity. Results No intracranial hemorrhage was observed. GI was similar between AP and TC groups. ADC and FA did not differ between AP and late TC groups in any structure. Compared to late MV brains, AP brains demonstrated significantly higher ADC (0.45±0.08 vs. 0.27±0.11, p=0.02) and FA (0.61±0.04 vs. 0.44±0.05; p=0.006) in the cerebral peduncles. Conclusions After 7days of AP support, WM integrity is preserved relative to mechanical ventilation. Type of study Research study. |
Databáze: | OpenAIRE |
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