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

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 neona...

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Autor principal: Iijima, Shigeo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910835/
https://www.ncbi.nlm.nih.gov/pubmed/35268331
http://dx.doi.org/10.3390/jcm11051240
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author Iijima, Shigeo
author_facet Iijima, Shigeo
author_sort Iijima, Shigeo
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description 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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spelling pubmed-89108352022-03-11 Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons Iijima, Shigeo J Clin Med Review 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. MDPI 2022-02-24 /pmc/articles/PMC8910835/ /pubmed/35268331 http://dx.doi.org/10.3390/jcm11051240 Text en © 2022 by the author. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Iijima, Shigeo
Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title_full Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title_fullStr Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title_full_unstemmed Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title_short Exchange Transfusion in Neonatal Sepsis: A Narrative Literature Review of Pros and Cons
title_sort exchange transfusion in neonatal sepsis: a narrative literature review of pros and cons
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910835/
https://www.ncbi.nlm.nih.gov/pubmed/35268331
http://dx.doi.org/10.3390/jcm11051240
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