To study the outcome of exchange transfusion in severe neonatal sepsis in neonates admitted in NICU at Dr. Bhim Rao Ambedkar memorial hospital, Raipur, Chhattisgarh, India
Abstract
Background: Sepsis is one of the most common causes of neonatal mortality and morbidity. Immaturity of the immune system, newborn infants are highly susceptible to systemic infection. Blood exchange transfusion in severe neonatal sepsis remove bacteria, bacterial toxins, and circulating pro-inflammatory cytokines, improve perfusion and tissue oxygenation, correct the plasma coagulation system and enhance immunological defence mechanisms.
Material and methods: This is a hospital-based, time-bound, analytical observational study conducted from January 2019 to December 2019 in the NICU of Dr. B.R.A.M. Hospital & Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India. The data was collected in pre-designed proforma, entered in Microsoft Excel and analysis was done using SSPS v 22.0.
Result: About 42 neonates were diagnosed with severe neonatal severe. Of which 23 (54.76%) were preterm, 42.24% were term neonates. Maximum 22 (52.38%) were VLBW, 4.76% were LBW and 19.05% were with normal birth weight. In the study two-third of 28 (66.67%) were outborn and one third were inborn. In the present study majority of 30 (71.43%) had EOS and 12 (28.57%) had LOS. In our study out of 42 study subjects 24 (57.14%) died and 18 (42.86%) were discharged after blood exchange transfusion. Of those who died 15 (62.5%) were preterm and of those discharged 10 (55.6%) were term neonates (p=0.349). Outborn neonates more died as compare to inborn though this was also not significant (p=0.133). In our study maximum 32 (76.19%) had cardiovascular dysfunction, 28 (66.67%) had respiratory system dysfunction and 11 (26.19%) had renal system dysfunction.
Conclusion: significant reduction of mortality in patients who underwent exchange transfusion, together with the no adverse effects observed, suggest that this procedure should be considered for the treatment of neonates with severe sepsis.
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References
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