{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:00:46Z","timestamp":1780891246624,"version":"3.54.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Our team has previously reported physiologic support by the EXTra-uterine Environment for Neonatal Development (EXTEND) of 105 to 117 days gestational age (GA) lambs for up to 28 days with normal organ maturation. However, the fetal lamb brain matures more rapidly, requiring the study of 90-105 day GA fetal lambs to assess more neurodevelopmentally equivalent lambs to the 23\u201325 week GA extreme premature infant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Extremely preterm lambs (90\u201395 days of GA) were delivered by C-section and supported by EXTEND. Estimated circuit flows were maintained at around 325\u2009ml\/kg\/min. After support on EXTEND, MRI and histopathologic analysis were performed and compared to 105\u2013112 days GA control lambs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The extremely preterm group includes 10 animals with a mean GA of 91.6 days, a mean weight at cannulation of 0.98\u2009kg and a mean length of stay on EXTEND of 13.5 days (10\u201321 days). Hemodynamics and oxygenation showed stable parameters. Animals showed growth and physiologic cardiac function. MRI volumetric and diffusion analysis was comparable to controls. Histologic brain analysis revealed no difference between study groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>EXTEND appears to support brain and cardiac development in an earlier gestation, less mature, lamb model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Impact<\/jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Prolonged (up to 21 days) physiological support of extremely preterm lambs of closer neurodevelopmental equivalence to the 24\u201328 gestational week human was achieved using the EXTEND system.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>EXTEND treatment supported brain growth and development in extremely preterm fetal lambs and was not associated with intraventricular hemorrhage or white matter injury.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Daily echocardiography demonstrated physiologic heart function, absence of cardiac afterload, and normal developmental increase in cardiac chamber dimensions.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>This study demonstrates hemodynamic and metabolic support by the EXTEND system in the extremely preterm ovine model.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41390-024-03287-0","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T15:28:02Z","timestamp":1717514882000},"page":"1616-1625","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Assessment of extremely premature lambs supported by the Extrauterine Environment for Neonatal Development (EXTEND)"],"prefix":"10.1038","volume":"96","author":[{"given":"Maureen","family":"Peers de Nieuwburgh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apeksha","family":"Dave","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer A.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin B.","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Slipenchuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Lieberman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohanad R.","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Crompton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alia Mohsin","family":"Choudhry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyun","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Rychik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus G.","family":"Davey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan W.","family":"Flake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"3287_CR1","doi-asserted-by":"publisher","first-page":"e20180933","DOI":"10.1542\/peds.2018-0933","volume":"143","author":"HT Myrhaug","year":"2019","unstructured":"Myrhaug, H. 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Flake holds multiple patents related to the EXTEND technology and is a Paid Medical Consultant for Vitara Biomedical Inc. Marcus Davey holds multiple patents related to the EXTEND technology and is employed by Vitara Biomedical Inc, Dan Crompton and Matthew Slipenchuk are employed by Vitara Biomedical Inc. All authors affiliated with the Center for Fetal Research at the Children\u2019s Hospital of Philadelphia received salary support from Vitara Biomedical Inc.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}