Exchange transfusion in the treatment of neonatal septic shock: A ten-year experience in a neonatal intensive care unit

Lorenza Pugni, Andrea Ronchi, Bianca Bizzarri, Dario Consonni, Carlo Pietrasanta, Beatrice Ghirardi, Monica Fumagalli, Stefano Ghirardello, Fabio Mosca

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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.

Original languageEnglish
Article number695
JournalInternational Journal of Molecular Sciences
Issue number5
Publication statusPublished - May 9 2016


  • Exchange transfusion
  • Neonatal infection
  • Neonatal sepsis
  • Neonatal septic shock
  • Neonate
  • Preterm infant
  • Therapy of septic shock

ASJC Scopus subject areas

  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Spectroscopy
  • Inorganic Chemistry
  • Catalysis
  • Molecular Biology
  • Computer Science Applications


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