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TV TIME
East Oregonian
Wednesday, April 26, 2017
Hope for preemies as artifi cial womb helps tiny lambs grow
WASHINGTON
—
Researchers are creating an
artifi cial womb to improve
care for extremely premature
babies — and remarkable
animal testing suggests
the fi rst-of-its-kind watery
incubation so closely mimics
mom that it just might work.
Today, premature infants
weighing as little as a pound
are hooked to ventilators and
other machines inside incu-
bators. Children’s Hospital
of Philadelphia is aiming for
a gentler solution, to give the
tiniest preemies a few more
weeks cocooned in a womb-
like environment — treating
them more like fetuses than
newborns in hopes of giving
them a better chance of
healthy survival.
The researchers created
a fl uid-fi lled transparent
container to simulate how
fetuses fl oat in amniotic fl uid
inside mom’s uterus, and
attached it to a mechanical
placenta that keeps blood
oxygenated.
In early-stage animal
testing, extremely premature
lambs grew, apparently
normally, inside the system
for three to four weeks, the
team reported Tuesday.
“We start with a tiny fetus
that is pretty inert and spends
most of its time sleeping.
Over four weeks we see that
fetus open its eyes, grow
wool, breathe, swim,” said
Dr. Emily Partridge, a CHOP
research fellow and fi rst
author of the study published
in Nature Communications .
“It’s hard to describe
actually
how
uniquely
awe-inspiring it is to see,”
she added in an interview.
Human testing still is
three to fi ve years away,
although the team already is
in discussions with the Food
and Drug Administration.
“We’re trying to extend
normal gestation,” said Dr.
Alan Flake, a fetal surgeon
at CHOP who is leading the
AP Photo/Michael Conroy
In this March 13 photo, students and teachers gather
for an all-school meeting called “circle” at Hope Acad-
emy in Indianapolis.
Overcoming opioids:
Special schools help
teens stay clean
INDIANAPOLIS (AP)
— When Logan Snyder
got hooked on pills after a
prescription to treat pain
from a kidney stone, she
joined the millions already
swept up in the nation’s grim
wave of addiction to opioid
painkillers.
She was just 14.
Youth is a drawback when
it comes to kicking drugs.
Only half of U.S. treatment
centers accept teenagers and
even fewer offer teen-fo-
cused groups or programs.
After treatment, adolescents
fi nd little structured support.
They’re outnumbered by
adults at self-help meetings.
Sober youth drop-in centers
are rare. Returning to school
means resisting offers to get
high with old friends.
But Snyder is lucky: Her
slide ended when her father
got her into a residential drug
treatment program. Now 17
and clean, she credits her
continued success to Hope
Academy in Indianapolis, a
tuition-free recovery school
where she’s enrolled as a
junior.
“I am with people all day
who are similar to me,” she
says. “We’re here to hold
each other accountable.”
The opioid epidemic,
which researchers say is
the worst addiction crisis
in U.S. history, has mostly
ensnared adults, especially
those in their 20s, 30s and
40s. But teens have not been
spared: Each day, 1,100 start
misusing pain pills. Opioids
killed 521 teens in 2015,
federal data show.
Not enough is known
about opioids and teen brains.
But getting hooked early is
trouble — the vast majority
of adults in treatment report
they started using as teen-
agers.
Researchers say young
recovering addicts do better
at places like Hope, special
schools that use peer commu-
nities to support sobriety.
There are only about three
dozen such schools in the
U.S., but interest is growing
among educators and health
offi cials because of the
opioid epidemic.
“I get a phone call every
day from somebody who
wants to start a recovery
high school,” says Rachelle
Gardner, an addiction coun-
selor who helped found Hope
in 2006 as a charter school
through the mayor’s offi ce.
“It’s horrible to watch young
people die. And who wants
that to be our legacy?”
Hope’s 41 teenagers have
abused marijuana, alcohol,
painkillers and heroin. Most,
like Snyder, have been
through residential treatment,
some more than once.
Others, like 17-year-old
Aiden Thompson, arrive with
no treatment after a crisis.
“I was really pissed off
because I didn’t want to
be here,” says Thompson,
who came to Hope last year
after his mom discovered
his vodka and pill stash.
“Everything they said, I was
like: ‘That can’t be true. No.
No way.’”
A week later, though,
he found himself talking in
group meetings.
Now, he said, “I don’t
even want to think about
where I would be” without
the school.
Teens like Snyder and
Thompson can change in
these settings, even after
years of drug abuse, in part
because social acceptance
is a fundamental need for
people their age.
The sway of positive peer
pressure — what students at
Hope call “the community”
— is quiet, almost intangible.
It’s as simple as two teens
passing in the hall: “You all
right?” says one boy. The
other nods, “Yeah, I’m all
right.”
A student council plans
events like coffee-and-
music mornings. To join the
council, a student must have
30 days of sobriety.
Random drug tests keep
it real. Failing a urine test
prompts a meeting with
recovery coach Brad Trolson,
who employs a technique
called motivational inter-
viewing, using open-ended
questions and refl ective
listening
to
encourage
students to think for them-
selves.
“They’re not used to
anyone saying, ‘What do you
think you should do next?’”
Trolson says.
It’s a daily fi ght, he says.
Many have addicted parents
or histories of abuse or
neglect, key risk factors for
addiction.
“Their wounds will start
to heal and they’ll come open
again,” he says. “You end
up addressing those wounds
over and over again.”
Thompson, who relapsed
over winter break, says he’s
learning to focus on one day
of recovery at a time. “I’m
clean for today and that’s all
that matters,” he says. “I don’t
want to put all this weight on
my shoulders to feel like I
have to stay clean forever. I
can just take it a day at a time
and not be freaked out by it.”
Children’s Hospital of Philadelphia via AP
In this drawing provided by the Children’s Hospital of
Philadelphia, an illustration of a fl uid-fi lled incubation
system that mimics a mother’s womb, in hopes of one
day improving survival of extremely premature babies.
project and considers it a
temporary bridge between
the mother’s womb and the
outside world.
Increasingly
hospitals
attempt to save the most
critically premature infants,
those born before 26 weeks
gestation and even those
right at the limits of viability
— 22 to 23 weeks. Extreme
prematurity is a leading cause
of infant mortality, and those
who do survive frequently
have serious disabilities such
as cerebral palsy.
The idea of treating pree-
mies in fl uid-fi lled incubators
may sound strange, but phys-
iologically it makes sense,
said Dr. Catherine Spong,
a fetal medicine specialist
at the National Institutes of
Health.
One of the biggest risks
for very young preemies is
that their lungs aren’t ready
to breathe air, she explained.
Before
birth,
amniotic
fl uid fl ows into their lungs,
bringing growth factors
crucial for proper lung
development. When they’re
born too soon, doctors hook
preemies to ventilators to
keep them alive but risk
lifelong lung damage.
Flake’s goal is for the
womb-like system to support
the very youngest preemies
just for a few weeks, until
their organs are mature
enough to better handle
regular hospital care like
older preemies who have less
risk of death or disability.
The device is simpler than
previous attempts at creating
an artifi cial womb, which
haven’t yet panned out.
How the “Biobag” system
works:
—The premature lambs
were delivered by C-section
and immediately placed into
a
temperature-controlled
bag fi lled with a substitute
for amniotic fl uid that they
swallow and take into their
lungs.
“We make gallons of
this stuff a day,” said fetal
physiologist Marcus Davey.
It’s currently an electrolyte
solution; he’s working to add
other factors to make it more
like real amniotic fl uid.
—Then the researchers
attached the umbilical cord
to a machine that exchanges
carbon dioxide in blood
with oxygen, like a placenta
normally does.
—The lamb’s heart circu-
lates the blood, without the
need for any other pump.
The researchers tested fi ve
lambs whose biological age
was equivalent to 23-week
human preemies, and three
more a bit older. All appeared
to grow normally, with blood
pressure and other key health
measures stable.