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Int. J. Mol. Sci. 2016, 17(5), 695; doi:10.3390/ijms17050695

Exchange Transfusion in the Treatment of Neonatal Septic Shock: A Ten-Year Experience in a Neonatal Intensive Care Unit

1
Neonatal Intensive Care Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 12, 20122 Milan, Italy
2
Neonatal Intensive Care Unit, Department of Pediatrics and Child Neuropsychiatry, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
3
Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 12, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: William Chi-shing Cho and Harry A. J. Struijker-Boudier
Received: 9 February 2016 / Revised: 5 April 2016 / Accepted: 27 April 2016 / Published: 9 May 2016
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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. View Full-Text
Keywords: neonate; preterm infant; neonatal infection; neonatal sepsis; neonatal septic shock; therapy of septic shock; exchange transfusion neonate; preterm infant; neonatal infection; neonatal sepsis; neonatal septic shock; therapy of septic shock; exchange transfusion
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MDPI and ACS Style

Pugni, L.; Ronchi, A.; Bizzarri, B.; Consonni, D.; Pietrasanta, C.; Ghirardi, B.; Fumagalli, M.; Ghirardello, S.; Mosca, F. Exchange Transfusion in the Treatment of Neonatal Septic Shock: A Ten-Year Experience in a Neonatal Intensive Care Unit. Int. J. Mol. Sci. 2016, 17, 695.

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