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Several barriers determine a lack of technological transfer between adult and pediatric care. In particular, this has been the case in the field of critical care nephrology where adequate devices and machinery for neonatal dialysis were completely missing. Where industry and large hospital centers do not provide sufficient advancement in pediatric and neonatal care, the academic world must take the lead even though in some cases adequate funding or resources are lacking. Then, the role of charity events and non-profit institutions and organizations may represent the correct approach to move the field forward. This has been the case for the development of CARPEDIEM (Cardio, Renal, pediatric, Dialysis, Emergency, Machine), where a combination of charity events and academic effort led to the most modern and unique neonatal dialysis machine. This is a nice example of how technological gaps in neonatal care can be overcome., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

We reported the cytokine profile in children <18 years old who received extracorporeal blood purification (EBP) for sepsis, rhabdomyolysis, hyperbilirubinaemia, acute respiratory distress syndrome or cytokine storm, and determined the factors affecting the cytokine removal kinetics. Plasma levels of 38 types of cytokine/chemokine were measured at pre-EBP, 12 and 24 h after initiating EBP. Altogether there were 11 eligible episodes admitted between April 2021 and December 2023. 72.7% were male with a median (25th, 75th percentile) age of 8.7 (5.4, 15.7) years old. The overall mortality rate was 45.5% but there was no EBP-associated mortality. EBP modalities included Cytosorb ® haemoadsorption (63.6%) and Oxiris ® haemodiafiltration (36.4%). Thirty-seven (97.4%) cytokines exhibited a concentration reduction following EBP, and 60.5% achieved a ≥50% concentration reduction. The median removal ratio was 35.0 (21.0, 53.7)% at 12 h and 55.0 (42.1, 83.1)% at 24 h. Survivors showed a significantly higher number of cytokines with ⩾50% removal ratio at 24 h (28 vs 7, p  = 0.017) and better removal ratio of anti-inflammatory cytokines at 12 h (67.9% vs 0%, p  = 0.030). A higher pre-EBP cytokine concentration and higher blood flow rate were significantly associated with better removal in 16 (42.1%) and 32 (84.2%) cytokines respectively. Our study demonstrated that both devices can safely and effectively reduce the cytokine and chemokine levels in critically ill children with various conditions., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.