A continuous renal replacement therapy (CRRT) device created for neonates can aid the management of acute kidney injury with positive outcomes, according to a study published online May 24 in The Lancet.
Claudio Ronco, M.D., from San Bortolo Hospital in Vicenza, Italy, and colleagues created a miniaturized Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM) specifically for neonates and small infants. The device was assessed with in-vitro laboratory tests and in critically ill neonates.
The researchers found that the primary characteristics of CARPEDIEM included the low priming volume of the circuit (<30 mL), miniaturized roller pumps, and accurate ultrafiltration control via calibrated scales with a precision of 1 g. A 2.9-kg neonate with hemorrhagic shock, multiple organ dysfunction, and severe fluid overload for more than 400 h was treated with the CARPEDIEM, using continuous venovenous hemofiltration, single-pass albumin dialysis, blood exchange, and plasma exchange. Organ function was restored and the neonate survived and was discharged from the hospital with only mild renal insufficiency that did not require renal replacement therapy, despite the severity of the initial illness.
“The CARPEDIEM could reduce the range of indications for peritoneal dialysis, widen the range of indications for CRRT, make the use of CRRT less traumatic, and expand its use as supportive therapy even when complete renal replacement therapy is not indicated,” the authors write.