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A Tiny Kidney Dialysis Machine For Children

In the world's first such breakthrough, scientists have developed a miniature kidney dialysis machine capable of treating the smallest babies and have also for the first time used it to safely treat a newborn baby with multiple organ failure.

To be announced on Friday by medical journal 'The Lancet', the new continuous renal replacement therapy (CRRT) machine — named CARPEDIEM (Cardio-Renal Pediatric Dialysis Emergency Machine) — was created to overcome the problems of existing dialysis machines that are only designed for adults and have to be adapted for use in newborns.

"Such modifications make adult devices inaccurate when used in infants who weigh less than 15 kg and can result in complications with fluid management and treatment delivery," said lead author professor Claudio Ronco from San Bortolo Hospital in Vicenza, Italy. "A major problem is the potential for errors in ultrafiltration volumes — adult dialysis equipment has a tendency to either withdraw too much fluid from a child, leading to dehydration and loss of blood pressure, or too little fluid, leading to high blood pressure and edema."

It is estimated that 18% of low-birth weight infants are affected by acute kidney injury and it is increasingly common in children admitted to hospital with an incidence of almost 20% in children admitted to intensive care.

Ronco therefore developed a miniature device for kidney support in newborns and infants weighing between 2 kg and 10 kg. It has the capacity to accurately handle very low blood and ultrafiltration flows compared with existing machines, allowing the use of a much smaller sized catheter than is typically used in children, which could prevent damage to blood vessels.
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