Breakthrough that helps lungs of premature infants develop

It is a breakthrough in medicine that could have come from the realms of science fiction but is very real to the families whose…

It is a breakthrough in medicine that could have come from the realms of science fiction but is very real to the families whose babies it saves.

Oxygen-bearing liquid pumped into the inadequately developed lungs of premature babies is being used as a way to deliver oxygen but also to help the lung tissue expand and develop.

The technique has been used by paediatric surgeon Mr Carl Davis of the Royal Hospital for Sick Children in Glasgow to save the life of one infant and a clinical trial is under way in the US to see how oxygen-bearing liquids could be used in other patients.

Premature babies are at high risk because various organs, particularly the lungs, have not had time to develop fully. The lungs often can't inflate fully to deliver adequate amounts of oxygen to the infant.

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Mr Davis, from Ireland, has developed a way to give these children more time by using the oxygen-bearing liquid, perflurocarbon, to stretch the poorly formed lungs until they are viable.

Film-makers employed the idea of an oxygen-bearing liquid used to allow a person to "breathe" underwater in the science fiction film, The Abyss, but the technique developed by Mr Davis is very real.

It has already been used to save one infant against tremendous odds. Aidan Findlay, aged one, had only a 5 per cent chance of survival after being born with one lung very small. The other, although slightly larger, had a hole in it. Until now that would have summed up a fairly hopeless outlook for such a young baby.

Survival lay in Mr Davis's pioneering work. Aidan is among one of the first babies in the world to have been saved by the technique.

As Mr Davis explained: "Aidan's lungs failed to develop properly in the womb and breathing was virtually impossible. His chances of survival without perflurocarbon were virtually nil.

"What we did first was put him on an extra corporeal membrane oxygenation machine which carries out the function of the lungs. That gave us the time to help Aidan grow new lungs.

"To allow that to happen we inserted perflurocarbon into the lungs and watched it begin its work of stretching and growing them. It is a heavy, dense liquid which carries no risk of introducing infection to the child.

"Its inert sterile qualities make it lung-friendly, so to speak, but we had to change it up to four times a day because the lungs shed tissue during the treatment. A debris floats to the top," Mr Davis said.

The treatment was carried out over a period of nine months after which Aidan left hospital with excellent lungs and breathing on his own. He has gained weight and is now making the milestones of a normal one-yearold infant.

"Most people would assume that fluid in the lungs would be bad. For example, many injuries which cause this to happen, such as pneumonia, burns or gunshots, harm the lungs by drowning them one tiny air sac at a time," Mr Davis said. In this case, filling the lungs with fluid can be a lifesaver.

The liquid ventilation technique was originally carried out in the US by Mr Ronald B. Hirshel, a paediatric surgeon based in Ann Arbor, Michigan. Evidence suggests that it saves one-quarter to a third of the adults and children who would otherwise die of respiratory failure. It is thought to have been used in fewer than 300 people worldwide.

Aidan's parents are naturally delighted. "We are so very aware that our son was saved by a very skilful surgeon and a pioneering treatment," his father, Philip, said. "Without Mr Davis and his team, we are sure Aidan would not have survived much after birth."

A large-scale clinical trial using perflurocarbon was launched last year in San Diego in an attempt to measure its success as a technique. It has great potential for a range of conditions.