When a premature newborn born in May at the North Austin Campus developed neonatal kidney injury (AKI) earlier this year, the Level IV NICU care team faced an extraordinary challenge. To support the infant’s tiny, fragile system, they turned to an advanced technology rarely used outside of major pediatric hospitals: the cardio-renal pediatric dialysis emergency machine known as Carpediem™.
Designed specifically for newborns and infants who are too small for standard dialysis machines, Carpediem™ allows providers to deliver continuous renal replacement therapy at a scale safe for even the smallest patients. For Austin, it marked the first time a baby received this treatment locally. The achievement brought together specialists from multiple disciplines across the hospital.
A New Level of Collaboration
Amy Gunderson, one of the NICU nurses who cared for the baby, said the experience highlighted how vital clear communication and shared trust are in complex cases.
“There are so many machines and monitors in play that it can be overwhelming for parents,” Amy said. “Part of our job is helping them understand what each one does, so they feel included in their baby’s care.”
Amy and her NICU colleagues worked closely with ECMO specialists and dialysis nurses to monitor every detail of the infant’s care. “It’s not just about what one person does,” she said. “When you have a small, tight-knit group that communicates well, you can take on something this complex with confidence.”
Specialized Support at Every Step
Respiratory therapist and ECMO specialist Rachel Snellenberger played a key role in managing the circulatory side of care. Her experience with life-support systems provided crucial insight into how to safely maintain blood flow through the Carpediem™ circuit.
“With Carpediem™, the volumes are so small that even minor changes matter. We’re constantly checking anticoagulation levels, looking for air bubbles and helping the bedside nurses troubleshoot,” Rachel explained.
Rachel described the case as a true collaboration. “We all rely on each other’s eyes and skills,” she said. “The NICU nurses know these babies best, and the renal team understands the machine’s nuances. It takes everyone working together.”
Engineering Care for the Smallest Patients
For Yadira Muñoz, a dialysis nurse with more than 20 years of experience, the experience was both familiar and entirely new.
“Carpediem™ resembles a regular hemodialysis machine, but it’s smaller and designed for babies based on their exact weight,” she said. “We’re able to do safely for infants what we used to only do for bigger kids or adults.”
Before beginning treatment, the Austin dialysis and NICU teams spent hours in training, practicing simulations and troubleshooting with the equipment manufacturer. “We got a really good in-service,” Yadira recalled. “They walked us through everything so that when the time came, we were ready. We followed every step, and the treatments went safely.”
As with any first-time procedure, there were challenges that required quick thinking and open communication. “There was a lot of troubleshooting,” she said. “We’d all put our brains together—nurses, physicians, ECMO specialists—to figure out what might be causing an alarm or pressure change. Everyone communicated constantly, and we kept each other updated.”
Learning and Leading Together
Across every shift and discipline, teamwork defined the experience. Yadira said input from each role shaped treatment decisions: “The NICU nurses would tell us, ‘The machine runs better when he’s on his left side,’ or ‘He gets cold when the treatment goes longer.’ That kind of information helps us adjust flow rates or temperature. It’s all connected.”
Rachel agreed, noting how the Austin campus fosters collaboration. “Everyone is willing to help,” she said. “If you have a question, someone will stop and work through it with you. It’s a learning environment for all of us.”
For Amy, those relationships and shared moments of problem-solving made the experience deeply meaningful. “You see how everyone’s expertise comes together for one purpose: to give a fragile baby the best chance we can,” she said.
A Milestone for Austin
For the Austin team, the successful use of the Carpediem™ system represents a technical milestone and reaffirmation of our mission and culture.
“It gives me a sense of accomplishment to know we can do this here,” Yadira said. “If another baby needs this treatment, we’ll be ready.”
As the Austin campus continues to grow, the collaboration among its nurses and specialists will continue to define an identity that is rooted in expertise, teamwork and compassionate care for every child.