Nephrology and Urology Fellow Friendship Hospital for Animals Washington, District of Columbia, United States
Abstract:
Background: Small patients have a large proportion of their blood volume (BV) in the extracorporeal circuit (EC) when undergoing extracorporeal therapies using adult human systems. This leads to a much higher incidence of hemodynamic instability during treatment and increased use of blood products to prime the EC. The CARPEDIEM system is designed for children < 10 kg and can be used to perform renal replacement therapy (RRT) and therapeutic plasma exchange (TPE).
Objective: To report the use of the CARPEDIEM system in small dogs.
Animals: Four dogs undergoing RRT and 2 dogs undergoing TPE using the CARPEDIEM system.
Methods: This is a retrospective study. Dogs who received RRT or TPE using the CARPEDIEM system were included. The following information was recorded from the medical record: patient weight, PCV before and after treatment, percentage of BV in EC, EC priming solution, hemodynamic parameters during treatment, and urea reduction ratio (URR) where applicable.
Results: Six RRT treatments were performed in 4 dogs. Two dogs had 1 TPE treatment each. Median bodyweight was 4.1 kg (Range 2.89-9.9). Median BV in EC was 10.3% (Range 3.7-17.9). Median delta PCV was 1% (Range -11-7). Median URR for 5/6 RRT treatments was 0.58 (Range 0.37-0.65). No patient required a blood prime. Fluid-responsive hypotension was noted during 1 RRT treatment. Transient hypotension that resolved without intervention was noted in both TPE treatments.
Conclusions and Clinical Importance: The CARPEDIEM system can be used to provide safe RRT and TPE in small patients.
