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Multicenter Study
. 2023 Aug;38(8):2827-2837.
doi: 10.1007/s00467-022-05871-0. Epub 2023 Jan 10.

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

Jennifer Battista  1 , Daniele De Luca  2 , Sergio Eleni Dit Trolli  3 , Lise Allard  4 , Justine Bacchetta  5 , Nourredine Bouhamri  6 , Carole Enoch  7 , Camille Faudeux  1 , Julie Guichoux  8 , Etienne Javouhey  9 , Karine Kolev  9 , Giulia Regiroli  2 , Bruno Ranchin  5 , Julie Bernardor  10   11
Affiliations
Multicenter Study

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

Jennifer Battista et al. Pediatr Nephrol. 2023 Aug.

Abstract

Background: The Cardio-Renal Pediatric Dialysis Emergency Machine (CA.R.P.E.D.I.E.M.®) 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® use.

Methods: This retrospective multicenter study included 19 newborns and six infants receiving CARPEDIEM® in five French pediatric and neonatal intensive care units. Laboratory parameters were collected at the initiation and end of the first CARPEDIEM® 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 veno-venous 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® is safe and effective in critically ill neonates and infants. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: CARPEDIEM®; Continuous kidney replacement therapy; Neonate.

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