World's First Miniaturized Dialysis Machine Saves Infants' Lives

By Joel Lindsey

A team of researchers in Italy has invented a new miniaturized dialysis machine designed specifically for treating newborn babies.

Previously, the only option available for treating babies in need of dialysis was to try adapting machines built for adults. This approach, researchers say, leads to some potentially significant complications.

“Such modifications make adult devices inaccurate when used in infants smaller than 15 kg and can result in complications with fluid management and treatment delivery,” Claudio Ronco, a researcher at San Bortolo Hospital in Vicenza, Italy who is involved with the project, said in a press release issued recently. “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.”

Ronco and the rest of the research team worked to address these issues by designing a device that could accurately handle small amounts of blood and low ultrafiltration flows. Not only would this allow for more accurate measurements and treatments when delivering dialysis to newborns and infants, but it would also allow doctors to treat babies using much smaller catheters, helping to prevent damage to blood vessels.  

The device is called CARPEDIEM (Cardio-Renal Pediatric Dialysis Emergency Machine), and details regarding its use in early clinical scenarios have been published recently in the journal The Lancet.

“We prospectively planned a 5-year project to conceive, design, and create a miniaturized CARPEDIEM, specifically for neonates and small infants,” researchers wrote in their report. “We created the new device and assessed it with in-vitro laboratory tests, completed its development to meet regulatory requirements, and obtained a license for human use. Once approved, we used the machine to treat a critically ill neonate.”

In late 2013, doctors at the San Bortolo Hospital used the CARPEDIEM device to treat a newborn suffering from multiple organ failures following a complicated delivery. According to the press release, the baby received renal treatment from the device for 20 days and experienced full restoration of organ function within 50 days.

“We have shown how the technical challenges of providing CRRT (continuous renal replacement therapy) can be overcome without relying on the adaptation of technology used in adult settings, and that a CRRT device designed specifically for use in neonates and small children can be used to safely and effectively treat acute kidney injury in small pediatric patients,” said Ronco. “We hope that our success will encourage the development of other medical technologies specifically designed for infants and small children.”

Image Credit: “Newborn Baby Leo at the Hospital.” Bridget Coila. 2010 CC BY-SA 2.0: https://creativecommons.org/licenses/by-sa/2.0/