Effect of exchange transfusion on mortality in neonates with septicemia

Mishra, Satish; Chawla, Deepak; Agarwal, Ramesh

doi:10.1002/14651858.cd012477

Cited by 2 publications

(2 citation statements)

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“…The number of articles published in the 1980s increased, that in the 1990s decreased, and only a few articles were published in the 2000s ( Figure 2 ). Moreover, in 2016 Cochrane published a review protocol to determine the efficacy of ET in reducing the mortality rate in neonates with septicemia and to ascertain the adverse effects associated with ET; however, the protocol was withdrawn in 2021 because it was out of date [ 60 ]. In the latest editions of a textbook on neonatal medicine [ 61 ] and in a representative textbook of neonatal infections [ 62 ], ET was not suggested as a treatment method for neonatal sepsis.…”

Section: Efficacy Of Exchange Transfusion In Managing Neonatal Sepsismentioning

confidence: 99%

Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons

Iijima

2022

JCM

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Neonatal sepsis remains a leading cause of morbidity and mortality worldwide. It is widely considered that exchange transfusion (ET) as an adjunctive treatment for neonatal sepsis has the ability to reduce mortality. This review summarizes the current knowledge regarding the efficacy of ET for neonatal sepsis. In neonatal sepsis, immune responses such as proinflammatory and anti-inflammatory cytokines play an important role in pathogenesis and can lead to septic shock, multiple organ failure, and death. Between the 1970s and 1990s several authors reported that ET was effective in the treatment of neonatal sepsis with sclerema. ET removes bacterial toxins and inflammatory cytokines from the blood by replacing it with fresh and immunologically abundant blood, thereby leading to improvement in tissue perfusion and oxygenation. Moreover, ET with fresh whole blood increases neutrophil count and immunoglobulin levels as well as enhancing neutrophil function. However, there is a lack of clear evidence for the clinical efficacy of ET. In addition, adverse events associated with ET have been reported. Although most complications are transient, ET can lead to life-threatening complications. Therefore, ET can be considered a last resort treatment to rescue neonates with severe sepsis with sclerema and disseminated intravascular coagulation.

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Section: Efficacy Of Exchange Transfusion In Managing Neonatal Sepsismentioning

confidence: 99%

Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons

Iijima

2022

JCM

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“…The procedure aimed at rapidly reducing serum bilirubin levels [ 2 ]. Traditional methods of exchange transfusion, where blood is extracted using the gravity method, have been associated with complications, including sepsis and hemodynamic instability [ 9 ]. In response to these challenges, our case introduces a novel technique employing two infusion pumps for the exchange transfusion, focusing on minimizing complications while ensuring optimal clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Novel Two-Infusion Pump Technique for Exchange Transfusion in a Hyperbilirubinemic Neonate

Reddy,

Rawat,

Karotkar

et al. 2024

Cureus

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Neonatal hyperbilirubinemia is a common concern in newborns, with ABO blood group incompatibility serving as a significant risk factor for severe jaundice. This case report outlines the successful management of a 2.5 kg female infant born to a primigravida mother with ABO incompatibility-induced hyperbilirubinemia. The neonate, born at 38.4 weeks via lower segment cesarean section, exhibited signs of jaundice at 91 hours of life, prompting screening and subsequent confirmation of serum bilirubin levels 26.4. The decision was made using the American Academy of Pediatrics (AAP) and categorized the child under high risk according to age and bilirubin level to implement a complete exchange transfusion using a novel approach with two infusion pumps. The unique aspect of this case lies in introducing a two-infusion pump technique, one to infuse and one to extract blood by inserting the IV set in opposite directions in the infusion pump to perform the exchange transfusion, aiming to minimize complications associated with traditional methods. Careful handling of umbilical venous and arterial lines, coupled with aseptic precautions, sought to mitigate the risk of sepsis. The procedure, conducted over two hours, demonstrated stability in vital signs and was monitored with a transcutaneous bilirubinometer. Post-transfusion, repeat serum bilirubin tests showed a decrease in bilirubin of 10.1, indicating the success of the novel exchange transfusion method. The infant was discharged after a five-day hospital stay, showcasing this innovative approach's potential efficacy and safety. This case contributes to the evolving strategies in neonatal care and emphasizes the importance of tailored interventions in managing hyperbilirubinemia associated with ABO incompatibility.

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Effect of exchange transfusion on mortality in neonates with septicemia

Cited by 2 publications

References 50 publications

Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons

Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons

Novel Two-Infusion Pump Technique for Exchange Transfusion in a Hyperbilirubinemic Neonate

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