Haemodynamics and cerebral oxygenation of neonatal piglets in the immediate <i>ex utero</i> period supported by mechanical ventilation or <i>ex utero</i> oxygenator

Key points The margin of human viability has extended to the extremes gestational age (<24 weeks) when lungs are immature and ventilator-induced lung injury is common. Artificial placenta technology aims extend gestation ex utero in order allow additional time develop prior entering an air-breathing environment. We compared haemodynamics cerebral oxygenation piglets immediate period post-oxygenator (OXY) transition against both paired measures uniquely transitioned onto mechanical ventilation (VENT). Post-transition, OXY became hypotensive with reduced carotid blood flow comparison VENT piglets. addition a pump oxygenator circuit may be required ensure haemodynamic stability post-transition period. Abstract Gestational at birth major predictor wellbeing; lower age, greater risk mortality morbidity. At margins weeks gestation) combined need for early ventilatory support means respiratory morbidity abrupt changes consequent on also contribute preterm-associated brain injury, including intraventricular haemorrhage. oxygenation, ongoing fetal development until mature enough safely true aimed characterize impact either or positive pressure neonatal piglet. 112 days (term = 115 days), pigs underwent instrumentation surgery (OXY, n 5) (VENT, 8). Blood (BP), rose from levels significantly higher than post-transition. piglet BP, oxygen delivery (DO2) decreased post-transition; however, regional saturation (rSO2) was maintained fetal-like levels. hypoxaemic retained CO2. Whether able maintain rSO2 under these conditions prolonged yet determined. Improvements lie maintaining BP enhancing flow.