Simulating the First Breath: Design of the Respiratory Reflex in a Fetal Manikin

Abstract

Extremely premature babies (24 to 28 weeks) have underdeveloped bodies, resulting in a survival rate of only 50-70%. To increase this rate, researchers around the globe are developing an artificial womb (AW), a safe environment that mimics the natural uterus, allowing the fetus to develop further. To successfully transfer the fetus from the natural uterus to the AW - while avoiding the respiratory reflex and thus neonatal transition - it is important that no air enters the lungs. To improve safety and minimize animal testing, the transfer procedure is first tested and trained using a fetal manikin simulation. To this end, the intent of this study was to perform a literature analysis to understand how the breathing reflex of a premature infant can be simulated in a fetal manikin. This study resulted in an overview of triggers known to initiate the respiration at birth and ways to detect these triggers, leading to a proposal for an electromechanical system. This proposal was incorporated into a realistic-looking prototype, which was subsequently evaluated with medical end users.