Miniaturization: the clue to clinical application of the artificial placenta.

The artificial placenta as a fascinating treatment alternative for neonatal lung failure has been the subject of clinical research for over 50 years. Pumpless systems have been in use since 1986.However,inappropriate dimension- ing of commercially available oxygenators has wasted some of the theoretical advantages of this concept. Dispropor- tional shunt fractions can cause congestive heart failure. Blood priming of large oxygenators and circuits dilutes fetal hemoglobin (as the superior oxygen carrier),is poten- tially infectious, and causes inflammatory reactions. Flow demands of large extracorporeal circuits require cannula sizes that are not appropriate for use in preterm infants. NeonatOx, a tailored low-volume oxygenator for this purpose, has proven the feasibility of this principle before. We now report the advances in biological performance of a refined version of this specialized oxygenator. Key Words: Artificial placenta—Extracorporeal life support— Interventional lung assist—Neonatal respiratory failure.