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Replacement of kidney function in neonates with acute kidney injury has been problematic and generally requires peritoneal dialysis. Italian investigators have developed a novel miniaturized dialysis apparatus, called CARPEDIEM (Cardio-Renal Pediatric Dialysis Emergency Machine) suitable for infants weighing between 2.5 kg and 10.0 kg. The machine has low priming volumes, can ultrafiltrate at low flow rates, and accurately measures fluid ultrafiltration within 1 g. Dialysis was accomplished using a 4.0 French dual-lumen catheter.
The authors report the first use of CARPEDIEM in a neonate with intracranial hemorrhage, liver failure, oligo-anuric renal failure, and fluid overload. Dialysis was started 4 days after birth and continued for 21 da…