THE MEN WHO STARE AT TINY GOATS

Probably to make up for the killing of goats by the First Earth Battalion, research groups have been keeping goat fetuses alive outside the womb, incubated and on ECMO via the umbilical chord.

Reading up on ECMO papers, I stumbled over this one Korean paper on using ECMO via the umbilical artery and vein to support goat fetuses. I thought that was pretty edgy, but found there are several reports on animal fetuses surviving outside the womb using ECMO as an artificial placenta, and making an artificial womb with a fluid incubator containing an artificial amniotic fluid. The fetuses are able to stay alive for several days up to several weeks, and in some cases they have been woken up and disconnected, surviving for up to a week without any support. Thinking about it, maybe they aren’t making up for the First Earth Battalion’s killing of goats after all…

BUT apart from being a mix of freaky animal experiements and a cool science fiction dream, the model might have future implications. As the authors comment in their discussion:

“By setting up the fetal research model, one could foresee the clinical usage of this kind of approach in premature neonates with severe lung hypoplasia and as a backup system for fetal operations.”

It could also lead to important advances in the understanding of fetal physiology and development, as researchers can study fetuses outside the womb over prolonged periods of time. It also shows the immense potential ECMO, or ECLS, has for keeping patients alive even if their their most important organs go down. The point is, as always, that the heart/lung failure must be reversible. ECLS just buys you time. In fetuses with immature organs, as well as in adults with circulatory or respiratory failure.

Extrauterine incubation of fetal goats applying the extracorporeal membrane oxygenation via umbilical artery and vein, J Korean Med Sci. 2002.

Development of an artificial placenta: survival of isolated goat fetuses for three weeks with umbilical arteriovenous extracorporeal membrane oxygenation, Artif Organs, 1993.

A new artificial placenta with a centrifugal pump: long-term total extrauterine support of goat fetuses, J Thorac Cardiovasc Surg, 1998.

Although the idea and technique is certainly not new, progress is being made. From these experiments back in the 60s(!), they were only capable of keeping fetuses alive for some minutes longer than by doing nothing. And even back then, they had the same dreams as the researchers have now, to support very premature babies. It’s interesting to read about researchers pushing the limits, but this is not ready for prime time yet – to put it mildly.

Here’s the paper from the 60’s:
A new method of oxygenation: a study of its use in respiratory support and the artificial placenta, Ann Surg, 1963.

You can also find the First Earth Battalion’s original field manual here.

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