CARPEDIEM® for continuous kidney replacement therapy in neonates and small infants: a French multicenter retrospective study

Background The Cardio-Renal Pediatric Dialysis Emergency Machine (CA.R.P.E.D.I.E.M.(R)) device is a continuous kidney replacement therapy (CKRT) equipment dedicated to neonates and small infants. This study aimed to assess the effectiveness, feasibility, outcomes, and technical considerations relating to CARPEDIEM (R) use.Methods This retrospective multicenter study included 19 newborns and six infants receiving CARPEDIEM (R) in five French pediatric and neonatal intensive care units. Laboratory parameters were collected at the initiation and end of the first CARPEDIEM (R) session.Results are presented as median [IQR] (range). Results At initiation, age was 4 days [2-13] (1-1134) with a body weight of 3.3 kg [2.5-4] (1.3-11.1). Overall, 131 sessions and 2125 h of treatment were performed. Treatment duration per patient was 42 h [24-91] (8-557). Continuous venovenous hemofiltration (CVVH) was performed in 20 children. Blood flow rate was 8 mL/kg/min [6-9] (3-16). The effluent flow rate for CVVH was 74 mL/kg/h [43-99] (28-125) and net ultrafiltration (UF) 6 mL/kg/h [2-8] (1-12). In the five children treated by hemodialysis, the blood and dialysate flow rates were 6 mL/kg/min [5-7] (4-7) and 600 mL/h [300-600] (120-600), respectively, while session duration was 8 h [6-12] (2-24). Most infants required a catheter between 4.5 and 6.5 French. Hemodynamic instability with a need for volume replacement occurred in 31 sessions (23%). Thrombocytopenia was observed in 29 sessions (22%). No hemorrhage occurred; all the patients survived the sessions, but only eight patients (32%) were alive at hospital discharge.Conclusions These data confirm that the use of CARPEDIEM (R) is safe and effective in critically ill neonates and infants.

Automated summary

This study aimed to assess the effectiveness, feasibility, outcomes, and technical considerations relating to CARPEDIEM (R) use in critically ill neonates and infants. The results show that the use of CARPEDIEM (R) is safe and effective in this population.