{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:26:38Z","timestamp":1786980398639,"version":"build-2736575974"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neonates with congenital kidney failure or acute kidney injury often require continuous kidney replacement therapy (CKRT). Historically, venous access for CKRT in this population has relied on non-approved adult catheters, commonly via the internal jugular (IJ) vein. Limited international reports describe using the umbilical vein for CKRT, but this practice is not widespread in the USA. The Nuwellis\u00ae dual lumen extended length catheter (dELC), originally created for adult ultrafiltration, may support alternative access for neonatal CKRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case series describes the clinical course of four neonates requiring CKRT using a 6 French Nuwellis\u00ae dELC placed in the umbilical vein at University of Iowa Stead Family Children\u2019s Hospital and Children\u2019s of Alabama. Patient demographics, CKRT prescriptions, access characteristics, and complications were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All four neonates underwent successful umbilical vein placement of the 6 Fr dELC. Weight at initiation ranged from 2.23 to 4.1\u00a0kg, with blood flow rates 20\u201340\u00a0mL\/min. Epoprostenol anticoagulation was used in three patients. Half of the cohort later transitioned to a tunneled catheter, and one transitioned to an IJ catheter following fluid removal. One catheter developed hub cracks likely related to lumen caps, and one patient experienced flow limitations attributed to positioning rather than catheter function. Two patients had no catheter-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Umbilical venous access using the 6Fr dELC may represent a viable alternative for neonatal CKRT. Coil reinforcement within the catheter may support patency and better functionality. Additional studies are needed to assess safety and broader applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>A higher resolution version of the Graphical abstract is available as Supplementary information<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07363-x","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T03:26:58Z","timestamp":1779074818000},"page":"3611-3616","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Novel use of the Nuwellis\u00ae dual extended length catheter (dELC) as umbilical venous access for neonatal kidney replacement therapy: case series"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7663-1119","authenticated-orcid":false,"given":"Kara","family":"Short","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Umberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meggie","family":"Mathis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallory","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacki","family":"Harmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsay","family":"Harshman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brynna","family":"Van Wyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Merrill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"7363_CR1","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1007\/s00467-016-3423-4","volume":"31","author":"L Tal","year":"2016","unstructured":"Tal L, Angelo JR, Akcan-Arikan A (2016) Neonatal extracorporeal renal replacement therapy-a routine renal support modality? 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None of the above companies had any role in the production of this manuscript. All other authors have no conflicts of interest.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}