A Pumpless Microfluidic Neonatal Lung Assist Device for Support of Preterm Neonates in Respiratory Distress.

Premature neonates suffer from respiratory morbidity as their lungs are immature, and current supportive treatment such as mechanical ventilation or extracorporeal membrane oxygenation causes iatrogenic injuries. A non-invasive and biomimetic concept known as the "artificial placenta" (AP) would be beneficial to overcome complications associated with the current respiratory support of preterm infants. Here, a pumpless oxygenator connected to the systemic circulation supports the lung function to relieve respiratory distress.

An integrated array of microfluidic oxygenators as a neonatal lung assist device: in vitro characterization and in vivo demonstration.

A miniaturized oxygenator device that is perfused like an artificial placenta via the umbilical vessels may have significant potential to save the lives of newborns with respiratory insufficiency. Recently we presented the concept of an integrated modular lung assist device (LAD) that consists of stacked microfluidic single oxygenator units (SOUs) and demonstrated the technical details and operation of SOU prototypes. In this article, we present a LAD prototype that is designed to accommodate the different needs of term and preterm infants by permitting changing of the number of parallel-stacked microfluidic SOUs according to the actual body weight.

Airway pressure release ventilation: a neonatal case series and review of current practice.

Background: The use of airway pressure release ventilation (APRV) in very low birth weight infants is limited.

Objective: To report the authors' institutional experience and to review the current literature regarding the use of APRV in pediatric populations.

Methods: Neonates <1500 g ventilated using APRV from 2005 to 2006 at McMaster Children's Hospital (Hamilton, Ontario) were retrospectively reviewed.

The use of the Laerdal infant resuscitator results in the delivery of high oxygen fractions in the absence of a blender.

Background: High oxygen increases morbidity and mortality. Current guidelines in Neonatal Resuscitation Programme (NRP) state if self-inflating bags are used with an input FiO2 of 1.0 without an oxygen reservoir a delivered safe FiO2 of approximately 0.

Positive end-expiratory pressure above lower inflection point minimizes influx of activated neutrophils into lung.

Objectives: To compare the effects of low vs. high tidal volume (Vt) with three positive end-expiratory pressure (PEEP) strategies on activated neutrophil influx into the lung.

Design: Prospective, randomized controlled animal study.