Baby breathes easy with laser-printed air tube
ANN ARBOR, Mich. – When a child stops breathing, it’s a mother’s worst nightmare. And a doctor’s first instinct is not to reach for a laser to solve the problem. But in a recent extreme case, a laser-based process did indeed save the day.
April Gionfriddo’s son, Kaiba, was born with tracheobronchomalacia, a defect that caused his airway to collapse. About 1 in 2200 babies is born with the condition each year; the defect usually corrects itself by the time a child is 2 or 3 years old. But in severe cases such as Kaiba’s, the defect can prevent breathing altogether. After Kaiba’s first incident, when he was 6 weeks old, he continued to stop breathing on a regular basis and required resuscitation daily.
That is, until doctors tried a 3-D laser-printed bioresorbable device under development at the University of Michigan. After obtaining emergency FDA clearance to create and implant a tracheal splint made from the biopolymer polycaprolactone, Dr. Glenn Green and Dr. Scott Hollister used a CT scan of Kaiba’s trachea/bronchus to develop the device. The custom-designed apparatus
was sewn around Kaiba’s airway to expand the bronchus and give it a skeleton to aid proper growth. The splint eventually will be reabsorbed by the body.
Doctors at the University of Michigan bioprinted this splint, custom-designed for Kaiba Gionfriddo’s trachea. It fits around the outside and supports the windpipe.
“The material we used is a nice choice for this,” said Hollister, professor of biomedical and mechanical engineering and associate professor of surgery. “It takes about two to three years for the trachea to remodel and grow into a healthy state, and that’s about how long this material will take to dissolve into the body.”
The image-based design and 3-D biomaterial printing process also can be adapted to building and reconstructing other tissue structures, the investigators said. They have used the process to build and test patient-specific ear, nose and bone (spine, craniofacial and long bone) structures in preclinical models.
“It was amazing,” said Green, associate professor of pediatric otolaryngology. “As soon as the splint was put in, the lungs started going up and down for the first time, and we knew he was going to be OK.”
Kaiba was taken off ventilator support three weeks after the February 2012 procedure and has been breathing easily ever since. “Quite a few doctors said he had a good chance of not leaving the hospital alive,” said Gionfriddo about her now 20-month-old. “At that point, we were desperate. Anything that would work, we would take it and run with it.”
The research appeared in the New England Journal of Medicine (doi: 10.1056/NEJMc1206319).
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