Ultra-small neonatal dialysis circuits do not maintain safe fluid balance

Excerpt

Nishimi and colleagues have designed a renal replacement device for tiny babies in which the extracorporeal circuit volume (ECV) is “ultra-small” at only 3.2 ml, by just using one operating syringe [1]. They note that their current system does not maintain fluid balance “accurately”, but that they “are working on” this “serious weakness”. Unfortunately, they will not be able to regulate the ultrafiltration rate without adding extra components to the circuit. This is because water moves across a dialyser according to the transmembrane pressure (TMP), and this cannot be regulated while the filter is exposed to the pressures in the blood access or return lines. …