1. Exchange Transfusion in the Treatment of Neonatal Septic Shock: A Ten-Year Experience in a Neonatal Intensive Care Unit
- Author
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Lorenza Pugni, Andrea Ronchi, B. Ghirardi, Dario Consonni, Monica Fumagalli, Bianca Bizzarri, Carlo Pietrasanta, Fabio Mosca, and Stefano Ghirardello
- Subjects
Male ,medicine.medical_specialty ,Neonatal intensive care unit ,neonatal sepsis ,medicine.medical_treatment ,Exchange Transfusion, Whole Blood ,Exchange transfusion ,Catalysis ,Article ,preterm infant ,Inorganic Chemistry ,lcsh:Chemistry ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Intensive Care Units, Neonatal ,medicine ,neonatal infection ,Humans ,030212 general & internal medicine ,Physical and Theoretical Chemistry ,neonate ,neonatal septic shock ,therapy of septic shock ,exchange transfusion ,Molecular Biology ,lcsh:QH301-705.5 ,Spectroscopy ,Cause of death ,Neonatal sepsis ,business.industry ,Septic shock ,Mortality rate ,Organic Chemistry ,Infant, Newborn ,Gestational age ,General Medicine ,medicine.disease ,Shock, Septic ,Computer Science Applications ,Surgery ,Neonatal infection ,lcsh:Biology (General) ,lcsh:QD1-999 ,Female ,business - Abstract
Septic shock, occurring in about 1% of neonates hospitalized in neonatal intensive care unit (NICU), is a major cause of death in the neonatal period. In the 1980s and 90s, exchange transfusion (ET) was reported by some authors to be effective in the treatment of neonatal sepsis and septic shock. The main aim of this retrospective study was to compare the mortality rate of neonates with septic shock treated only with standard care therapy (ScT group) with the mortality rate of those treated with ScT and ET (ET group). All neonates with septic shock admitted to our NICU from 2005 to 2015 were included in the study. Overall, 101/9030 (1.1%) neonates had septic shock. Fifty neonates out of 101 (49.5%) received one or more ETs. The mortality rate was 36% in the ET group and 51% in the ScT group (p = 0.16). At multivariate logistic regression analysis, controlling for potentially confounding factors significantly associated with death (gestational age, serum lactate, inotropic drugs, oligoanuria), ET showed a marked protective effect (Odds Ratio 0.21, 95% Confidence Interval: 0.06–0.71; p = 0.01). The lack of observed adverse events should encourage the use of this procedure in the treatment of neonates with septic shock.
- Published
- 2016