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Michela Franchini, Stefania Pieroni, Claudio Passino, Michele Emdin, Sabrina Molinaro
Modern medicine remains dependent on the accurate evaluation of a patient's health state, recognizing that disease is a process that evolves over time and interacts with many factors unique to that patient. The CARPEDIEM project represents a concrete attempt to address these issues by developing reproducible algorithms to support the accuracy in detection of complex diseases. This study aims to establish and validate the CARPEDIEM approach and algorithm for identifying those patients presenting with or at risk of heart failure (HF) by studying 153,393 subjects in Italy, based on patient information flow databases and is not reliant on the electronic health record to accomplish its goals...
2018: Frontiers in Public Health
Marco Sartori, Arianna Loregian, Silvana Pagni, Silvia De Rosa, Fiorenza Ferrari, Leopolda Zampieri, Mirella Zancato, Giorgio Palú, Claudio Ronco
BACKGROUND: Continuous veno-venous hemofiltration (CVVH) could affect the pharmacokinetic profile of linezolid (LZD). The aim of this study was to evaluate the LZD extracorporeal clearance using an in vitro CVVH model. METHODS: A sham miniaturized CVVH circuit (CARPEDIEM; Bellco, Mirandola, Italy) was set up with a polysulfone hemofilter (0.25 m; cutoff 50,000 Da) for 240 minutes using normal saline solution (0.9% wt/vol NaCl) and blood (n = 6) spiked with LZD. Drug solution samples were collected during CVVH at 10, 30, 60, 120, and 240 minutes...
October 2016: Therapeutic Drug Monitoring
Anna Lorenzin, Francesco Garzotto, Alberta Alghisi, Mauro Neri, Dario Galeano, Stefania Aresu, Antonello Pani, Enrico Vidal, Zaccaroa Ricci, Luisa Murer, Stuart L Goldstein, Claudio Ronco
BACKGROUND: The CARdiorenal PEDIatric EMergency (CARPEDIEM) machine was originally designed to perform only continuous venovenous hemofiltration (CVVH) in neonatal and pediatric patients. In some cases, adequate convective clearance may not be reached because of a limited blood flow. In such conditions, the application of diffusive clearance [continuous venovenous hemodialysis (CVVHD)] would help optimize blood purification. In this study, the CARPEDIEM™ machine was modified to enable the circulation of dialysis through the filter allowing testing of the performance of CARPEDIEM™ machine in CVVHD...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Francesco Garzotto, Monica Zanella, Claudio Ronco
The provision of continuous renal replacement therapies (CRRT) to small children has generally required the adaptation of adult machines and modified operational characteristics. CRRT prescription for younger and smaller children versus adults differs significantly due to problems concerning the extracorporeal blood volume, the need for circuit blood priming, and the adaptation of machines designed for adult-sized patients. Moreover, the provision of renal replacement therapy to infants and neonates presents a unique problem: no more than 10-15% of their blood volume should be removed by the extracorporeal circuit to prevent hypotension and anemia...
2014: Nephron. Clinical Practice
Daljit K Hothi
Within paediatric intensive care units (PICU), clinicians face an increasing demand to support neonates and small infants with acute renal injury or medication-resistant oedema. Of all PICU admissions, fluid overload or a requirement for renal replacement therapy (RRT) is a poor prognostic factor, resulting in death in 25-50 % of such babies. For those who survive, RRT is supportive until kidney recovery, but up to 30 % of babies may have chronic kidney sequelae. Owing to their size, neonates and small infants present specific challenges for dialysis...
October 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Licia Peruzzi, Roberto Bonaudo, Alessandro Amore, Federica Chiale, Maria Elena Donadio, Luca Vergano, Rosanna Coppo
Neonatal sepsis due to E. coli is often complicated by multiple organ failure (MOF) and a high mortality risk. We report the case of a term newborn discharged in good condition who suddenly fell into septic shock after 11 days and required immediate resuscitation, volume expansion and a high-dosage amine infusion. Extremely severe metabolic acidosis, disseminated intravascular coagulation (DIC) with diffuse bleeding, and unstable hemodynamic status with oliguria turned into strict anuria, and the patient became anuric...
May 2014: Case Reports in Nephrology and Urology
Ellen F Carney
No abstract text is available yet for this article.
August 2014: Nature Reviews. Nephrology
Claudio Ronco, Francesco Garzotto, Alessandra Brendolan, Monica Zanella, Massimo Bellettato, Stefania Vedovato, Fabio Chiarenza, Zaccaria Ricci, Stuart L Goldstein
BACKGROUND: Peritoneal dialysis is the renal replacement therapy of choice for acute kidney injury in neonates, but in some cases is not feasible or effective. Continuous renal replacement therapy (CRRT) machines are used off label in infants smaller than 15 kg and are not designed specifically for small infants. We aimed to design and create a CRRT machine specifically for neonates and small infants. METHODS: We prospectively planned a 5-year project to conceive, design, and create a miniaturised Cardio-Renal Pediatric Dialysis Emergency Machine (CARPEDIEM), specifically for neonates and small infants...
May 24, 2014: Lancet
Emmanuella Guenova, Franziska C Eberle, Gisela Metzler, Martin Schaller
No abstract text is available yet for this article.
November 2012: European Journal of Dermatology: EJD
Claudio Ronco, Francesco Garzotto, Zaccaria Ricci
Pedriatric acute kidney injury (AKI) is a well-described clinical syndrome that is characterized by a reduction of both the urine output and glomerular filtration rate. AKI in critically ill children is typically associated with multiple organ dysfunction. A dramatic increase in the incidence of AKI in pediatric intensive care units has been observed in the last 10 years. Unfortunately, the absence of sufficiently effective preventive and therapeutic measures at the present time has limited significant improvements in AKI care...
August 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
C Ronco, A Davenport, V Gura
New directions in dialysis research include cheaper treatments, home based therapies and simpler methods of blood purification. These objectives may be probably obtained with innovations in the field of artificial kidney through the utilization of new disciplines such as miniaturization, microfluidics, nanotechnology. This research may lead to a new era of dialysis in which the new challenges are transportability, wearability and why not the possibility to develop implantable devices. Although we are not there yet, a new series of papers have recently been published disclosing interesting and promising results on the application of wearable ultrafiltration systems (WUF) and wearable artificial kidneys (WAK)...
2011: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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