In vitro measurements of ultrafiltration precision in hemofiltration and hemodialysis devices used in infants, Part 2: Comparison of PrisMax and CARPEDIEM with previous data on NIDUS, Prismaflex and Aquarius

Background: We sought to determine in vitro whether the PrisMax and CARPEDIEM hemofiltration and hemodialysis devices can reliably deliver ultrafiltration (UF) control that is sufficiently precise to treat infants. Methods: We have previously measured the precision of UF control of the Prismaflex, Aquarius and NIDUS devices by in vitro testing with a bag of saline set up as a dummy patient, and comparing the differences between the UF set and displayed by the devices, and the actual fluid removal or addition measured by precise weighing. Here we have tested the PrisMax (updated version of Prismaflex) and the CARPEDIEM using the same method. Results: The variances of the setting vs. actual errors, and display vs. actual errors after 15 min of ‘treatment’ with the PrisMax and CARPEDIEM were similar, but were significantly larger than in the NIDUS, and much smaller than in the Prismaflex. However, after a 4-h ‘treatment session’, the cumulative errors were still within ± 9 mL for these devices, compared with a maximum error of 2.6 mL in the NIDUS, and a deviation of -37.5 mL in the Prismaflex. Conclusions: The PrisMax and the CARPEDIEM have adequate precision to be used in infants. The only device with UF error below 3 ml in 4 h is the volumetrically-controlled NIDUS. We recommend that regulatory bodies should introduce UF precision-testing for devices intended for use in infants.