Frequently Asked Questions


Most frequent questions and answers

The PLS system is currently designed for a gestational age between 24 and 28 weeks.

The PLS system is designed to improve the current standard of care in the Neonatal intensive care unit (NICU). The reason why the PLS system targets newborns between 24-28 week is because before 24 weeks the newborn is too small and premature to undergo all envisioned procedures and after 28 weeks the baby can get successful treatment in the current Neonatal intensive care unit (NICU).

Unfortunately, not. Before 24 weeks the newborn is too small and vulnerable for it to be transferred and kept in the PLS system. This is currently not feasible to accomplish.

The PLS project works as a team of people with different expertise. That is why each expert defines the most demanding thing differently. Also, the project is still ongoing.

Currently, the project partners define their biggest challenge as how to establish the oxygen supply through the umbilical cord. During the transfer from the mother into the PLS system we calculated that the baby’s umbilical cord needs to be cannulated (placing a canula in the veins) in under 3 minutes.

The project is also working hard to assure that the blood does not clot during the treatment in the PLS system where blood is in contact due to foreign-body reactions.

The transfer between the mother and PLS system is also a technological challenge in itself- after all it requires completely new devices, procedures, and protocols.

The project also still works hard on making sure that the oxygenator will always provide sufficient oxygen to the baby.

And that the baby’s health is monitored accurately, that the clinical decision support system is in place and how the system reacts and adopts to the clinician’s interventions (say increasing oxygen intake).

This is a technically and clinically complex project. Also, the societal and ethical aspects are important. If the PLS project succeeds at making the first prototypes, these need to be evaluated in pre-clinical and clinical studies. How this could look like it still not clear. Neither is when this will happen.

The project does everything they can to make the PLS system a reality and therefore also prepares the next steps towards bringing the PLS to the market and to the premature babies who need it most. However, at this stage we cannot predict when this will become available.

Because the current air-based incubators have proven non-optimal to further improve the health of extremely premature babies.

To design such a liquid-filled incubator is a technological, medical, ethical, and societal challenge. The research and development need to cross the boundaries of disciplines focusing on the hardware, software, and design part. But also, medical, and ethical experts need to be involved. This project really pushes the boundaries of what is technically and medically feasible and socially accepted. Furthermore, we do not have a lot of information about how the babies’ organs behave before, during and shortly after birth. This project is therefore dealing with uncertainties and risks. All these things can explain why the PLS system has not yet been developed and is available to extremely premature babies.

This is a good question, and we are currently debating this with our ethical experts. It is surely a question we want to discuss with parents of premature babies and their advocates and close ones. Already now parents of extremely premature born babies keep two birth dates in mind- the actual birth and the time the baby is released from the Neonatal intensive care unit (NICU).

At the Neonatal intensive care unit (NICU) parents can help with routine things like changing a diaper or can have skin-to-skin contact, a method often called kangaroo care. However, as the PLS system will be a closed system this will not be possible. The PLS system is designed to mimic the situation in the mother’s womb- so we are currently thinking about ways on how to interact with the baby through movement, speakers (as you would interact with it in the womb). Other possibilities could be seeing the baby through inbuilt cameras or listening to the baby’s noises such as its heartbeat- as you would during your doctor’s appointment. However, these all are also ethical questions and personal preferences which need to be discussed with parents, caregivers, and advocates. However, this is beyond the scope of the PLS project and will hopefully be part of a follow-up project. Within the project all key aspects of the planned PLS system are addressed in the Advocate Advisory Board in which also parents who experienced extremely immature birth are a member.

This is very unlikely, as the technological challenges are too complicated at this point. We are though, already working in comfort and bonding aspects of the PLS system. Trying to answer questions like: How can parents form a bond with the premature baby in the PLS system? What do they and their caregivers find important?

No. The PLS system is only designed to optimize the current state-of-the-art neonatal intensive care (NICU) for extremely preterm babies and does not aim to replace natural pregnancy. We understand that the PLS system can come across as futuristic. That is why we want to discuss this development with (affected) parents, close ones of premature babies, caregivers, clinicians, designers and engineers.