Inside Pediatrics Spring 2018

the country to successfully adapt Aquadex for use on infants, and the device is now being used at other major children’s hospitals, including Cincinnati Children’s, Boston Children’s Hospital and Seattle Children’s Hospital. “We do more dialysis in newborns than other hospitals in the world,” Askenazi said. “We have cared for 70 babies with CRRT and have great success in initiating the machine without cardiovascular compromise, which was a problem before using Aquadex. Our survival rate in babies has increased from 30 percent to 55 percent over the last few years.” PICAN is also the driving force behind the international Neonatal Kidney Collaborative (NKC). Under the direction of Askenazi, this network of neonatologists, pediatric nephrologists, epidemiologists and statisticians from the U.S., as well as India, Canada, and Australia, are committed better understanding AKI in neonates.

The inaugural project of NKC is the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study. The 24-center study captured data from over 2,000 neonates admitted to the NICU who were on intravenous fluids for at least 48 hours. “We have learned a tremendous amount from the AWAKEN database. We can now show that AKI is very common in select groups of patients. Those patients with AKI were four times more likely to die, even after controlling other factors that are associated with neonatal death,” Askenazi said. “We have recently reported that caffeine can be a protective agent against AKI, and we have 12 other manuscripts in preparation as well. Our plans are to submit a [National Institutes of Health] grant to continue our research and answer more questions on this topic in the future.” For more information, visit childrensal.org/nephrology .

The PICAN team at Children’s of Alabama, standing from left: Traci Henderson, RPh; Suzanne White, RN; Gwen Powers, RN; Krysta Smith; Lynn Dill, RN; Suzanne Gurosky, RN; Louis Boohaker, MPH; Susan Keeling, RN; Daryl Ingram, RN; Paige Perry, RN; Kara Short, MSN, CRNP and Wendy Shirley, RN. Seated, from left: Tennille Webb, MD; David Askenazi, M.D.; Michael Seifert, M.D. and Brian Halloran, MS.

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