In Brief
A team has successfully kept five extremely premature lambs alive by letting them "breathe" through artificial placenta, while their lungs and heart heal and develop.

Too Young to Breathe

Babies born before 24 weeks are at a very high risk of death, and even if they do survive, they have a high risk of having long-term disabilitiesAccording to George Mychaliska, director of the University of Michigan’s Fetal Diagnosis and Treatment Center, “one of the gravest risks for extremely premature babies is undeveloped lungs that are too fragile to handle even the gentlest ventilation techniques.”

He adds, “if a baby’s lungs are severely immature, they cannot provide the brain, heart, and other organs the oxygen they need to survive.”

In order to improve survival rates for severely premature babies, researchers made a logical move that, for some reason, has not been considered before: By recreating the baby’s environment in the womb as if it were still a fetus.

“We thought, ‘Why don’t we solve the problem of prematurity by recreating the intrauterine environment?’’” Mychaliska says. “Maybe we should treat this tiny baby like a fetus. Maybe we should treat these babies as if they are still in the womb.”

Simulating the Womb

The team tried connecting extremely premature lambs to artificial placenta, which oxygenates their bodies without them ever having to breathe through their lungs, utilizing as process called extracorporeal membrane oxygenation (ECMO). This allows oxygenation while leaving the heart and lungs to rest and heal, instead of exhausting them further.

Five lambs were successfully kept alive for a week.

“This is a complete paradigm shift. Our research is still in a very preliminary stage, but we’ve passed a significant milestone that gives us promise of revolutionizing the treatment of prematurity. Although many of our current therapies are lifesaving, they are not designed for premature babies and are often ineffective or contribute to complications,” Mychaliska says.

The research has been awarded a grant by the National Institutes of Health, which would hopefully accelerate development.