Continuous kidney replacement therapy with CARPEDIEM® of premature and low birth weight neonates from the French registry
Background: Acute kidney injury (AKI) affects 30% of hospitalized pediatric patients, with high mortality in neonates. The Cardio-Renal Pediatric Dialysis Emergency Machine® (CARPEDIEM®) is a continuous kidney replacement therapy (CKRT) device designed for infants weighing 2.5–9.9 kg. Methods: We re...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
16 July 2025
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| In: |
Pediatric nephrology
Year: 2025, Pages: 1-9 |
| ISSN: | 1432-198X |
| DOI: | 10.1007/s00467-025-06896-x |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s00467-025-06896-x
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| Author Notes: | Jennifer Battista, Sergio Eleni dit Trolli, Bruno Ranchin, Justine Bacchetta, Julien Frederic Baleine, Danièle De Luca, Stéphane Decramer, Carole Enoch, Camille Faudeux, Marc Fila, Giulia Regiroli, Claus Peter Schmitt, Julie Bernardor |
| Summary: | Background: Acute kidney injury (AKI) affects 30% of hospitalized pediatric patients, with high mortality in neonates. The Cardio-Renal Pediatric Dialysis Emergency Machine® (CARPEDIEM®) is a continuous kidney replacement therapy (CKRT) device designed for infants weighing 2.5–9.9 kg. Methods: We retrospectively evaluated the technical feasibility, efficacy regarding solute and fluid removal, tolerability and patient outcomes of CKRT with CARPEDIEM® in preterm and low birth weight (LBW) neonates (< 2.5 kg) with AKI, treated in six French pediatric intensive care units. Results: Ten neonates with a median gestational age of 31 [interquartile 29–32] (range 25–38) weeks and a birth weight of 1.1 [IQ 1.0–1.7] (0.6–2.0) kilograms received continuous veno-venous hemofiltration (CVVH) during 22 sessions. CVVH was initiated at a median age of 6 [2–12] (1–72) days and a weight of 1.9 [1.5–2.4] (1.3–2.8) kg. All CVVH sessions achieved efficient blood purification. At CVVH initiation fluid overload was 29 [21–39] (11–68)% and improved until the end of treatment to 16[8–18] (0–40)% (p = 0.04). Thrombocytopenia, requiring platelet transfusion, and hypotensive episodes were the main complications observed in 14 and 13 sessions. No deaths occurred during the CARPEDIEM® treatment but all except one neonate died 6 [1–9] (1–63) days later, mainly due to multi-organ failure or ethical considerations linked to severe brain injury. Conclusion: CVVH using CARPEDIEM® is technically feasible and effective in neonates with a birth weight below 2.5 kg with AKI and multi-organ dysfunction with the potential to improve clinical management. Further studies are needed to define adequate timing, dosing, and the impact on patient outcome. |
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| Item Description: | Veröffentlicht: 16. Juli 2025 Gesehen am 26.11.2025 |
| Physical Description: | Online Resource |
| ISSN: | 1432-198X |
| DOI: | 10.1007/s00467-025-06896-x |