Hi everyone, we're here at McMaster University in Hamilton, Ontario
where tons of innovative research happens each day.
One of these labs is working on creating a device that will
have a massive impact on our tiniest humans.
This emerging technology is coming from the Center for Advanced Micro ElectroFluidics,
a research institute found right on campus.
This lab has been helping premature babies with difficulties breathing.
Many premature infants experience difficulty breathing because their respiratory system
has not fully developed by the time that they are born.
In short, gas exchange occurs in small sacs within our lungs called alveoli
which are covered in a solution called surfactant.
Surfactant is needed to keep airways open
for breathing, and without it, the alveoli would collapse.
A fetus starts making surfactant in the womb.
However, premature infants, born before 37
weeks gestation, may not have made enough surfactant.
This is why many preterm infants may experience lung impairment.
This lung impairment may progress to respiratory distress syndrome (or RDS) where the infant
will need assistance breathing from a device.
Although technologies exist to help with breathing,
there are drawbacks when using these devices
in this small and vulnerable population.
Currently, mechanical ventilation serves as the main intervention for treating pre-terms
with respiratory distress syndrome.
However, mechanical ventilation can damage the lungs and cause a series of pulmonary
complications.
Some complications include infection to one or both lungs and rupturing of the membranes.
If mechanical ventilation proves to be unsuccessful
for treating respiratory distress syndrome,
then the pre-term is placed on Extracorporeal Membrane Oxygenation, also known as ECMO,
which comes with its own drawbacks.
One of the main issues with ECMO is that it is highly invasive as it requires a surgery
to access the main blood vessels.
Additionally, ECMO requires a lot of blood, and a typical 1 kg preterm’s body only contains
seven tablespoons of blood.
At this point, you may be wondering why this issue can’t just be solved with adult donor
blood.
Well, the issue with using adult blood is that it is different from the blood of a newborn.
Babies' blood cells have a higher affinity for oxygen when compared to those of adults.
To circumvent many of these problems, the researchers at the Center for Advanced Micro
ElectroFluidics created the artificial placenta.
This device gets its name because it functions to provide oxygen to a newborn in the same
manner that a placenta would provide oxygen in the womb.
In the womb, a fetus is surrounded by amniotic fluid so it cannot get oxygen from its lungs
which are also still developing.
Instead, a fetus’s umbilical arteries carry deoxygenated blood to the placenta.
In the placenta, the mother's oxygenated blood meets with the fetuses' deoxygenated blood
at the chorionic membrane, where gas exchange occurs.
The oxygenated blood then returns to the fetus
through the umbilical vein and is pumped throughout
its body.
The artificial placenta device works under the same premise, however, instead of gas
exchange occurring within the body, it occurs in the outside air.
After birth, the umbilical cord is cut, detaching it from the placenta.
The baby is then able to take its first breaths using its own lungs.
However, in the case of an infant needing assistance breathing, this device would be
connected to the umbilical artery and vein where the placenta was previously attached.
The infant's heart would pump deoxygenated blood to the device.
Within the artificial placenta device, gas exchange would occur.
Then oxygenated blood would return to the infant through the umbilical vein.
This is a passive process because hospitals would not have to manage the device.
Rather, the body’s natural self-regulation process controls the blood pressure and flow,
and pumps the baby's blood through the device.
The idea behind the artificial placenta device
offers a promising solution to newborn respiratory distress.
Researchers in this lab are currently testing the device in animal trials so that it can
one day be used in hospitals.
One of the Master's students working in this lab has offered to show us around their lab
and give a look at some of the developments they are making with their device.
Hello everyone, this is Neda Saraei.
I'm a Master's student in Biomedical Engineering.
Over the last decade, our research group has been using microfabrication technologies to
overcome the shortcomings of hollow fiber membranes and introduce the next generation
of blood oxygenators.
Microfluidic blood oxygenators have shown promising improvements in gas exchange
compared to convention ECMO
due to mimicking the nature of the lungs by reducing the size of the blood
channels as small as the capillaries in the lungs.
Our approach is different from other groups active in this area.
Typically, any oxygenators, including the microfluidic ones, have three main components:
the blood compartment, the gas compartment, and a gas-permeable membrane or hollow fibers.
The microfluidic blood oxygenators we have been developing do not have any gas channels
or chambers.
Therefore, they can provide the required gas transfer simply in room air, as our lungs do.
Our microfluidic blood oxygenators consist of two nonporous membranes, one inlet, one
outlet, and a blood vascular network responsible for distributing blood uniformly between two
gas-permeable membranes.
We also designed and developed a composite gas-permeable membrane for our oxygenators,
which improved the mechanical stability of our devices.
This membrane is made of PDMS, a silicone-based polymer
that plays a central role in the gas transfer,
and a porous Teflon membrane acts as a scaffold to reinforce PDMS that does
not have excellent mechanical properties.
Dr. Ravi Selvaganapathy and his team are currently in the clinical validation stage of this project.
The team believes that once the validation stages are completed, there is a potential
for this innovation to expand to other areas.
Currently, animal trials have shown that this innovation can support newborns weighing 1-2
kilograms.
The team is hoping that in the future they can extend this technology to young children
and eventually, even the adult population.
Another way they plan to expand this technology is to modify it so that it can supply nutrients
in addition to oxygen.
Adding this dual feature would allow the artificial
placenta to support more conditions, since
as of right now it is restricted to only supporting
newborns with RDS.
The future of the artificial placenta technology
is promising and would have significant implications
here in Canada and abroad.
Dr. Ravi explains these implications further.
After cannelation then it has very minimal risk because there is no pumping of the blood,
there is no external connections.
There is no requirement for power, so it doesn't require any power to operate, and it is designed
to get oxygen from air rather than any specialized enriched oxygen source, and therefore you
can use it in a variety of settings, even where there's no power or there's no oxygen
cylinders and things of that sort.
So it is a convenient way for many, many hospitals,
not only in Canada, but also across the world
to provide oxygenation support when ECMO is not always available.
Before we can see the benefits of this device in society, future directions of research
include extending the length of time it can be used for, assessing possible good or bad
long-term effects on the heart or brain, and finally testing the technology in a clinical
trial on real babies.
There is still a long way to go and many developments
to be made but this device would revolutionize
the way we look at medicine.
It exemplifies how valuable it can be to create technologies that mimic concepts from our
natural bodily systems to solve unique medical problems.