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[Exchange transfusions in sepsis after the pediatric open heart surgery]
N Kawada1, Y Nakamura, M Yamagishi
1Department of Cardiac Surgery, Jikei University Hospital, Tokyo, Japan.
Insights
Exchange blood transfusion effectively treated septic children post-open heart surgery. This method stabilized patients, improving key health indicators and aiding recovery from sepsis.
Area of Science:
- Pediatric Cardiology
- Neonatal Sepsis Management
- Cardiovascular Surgery
Background:
- Sepsis poses a significant risk to pediatric patients undergoing open heart surgery.
- Effective management strategies for post-surgical sepsis in neonates are critical.
Observation:
- Two cases of pediatric septic shock following open heart surgery were observed.
- Exchange blood transfusion using irradiated and dialysed fresh blood was employed as a treatment.
Findings:
- Significant improvements were noted in white blood cell count, C-reactive protein (CRP), total bilirubin (T-Bil), and blood urea nitrogen (BUN) post-transfusion.
- Hemodynamic stability, including blood pressure and urine output, was maintained throughout the procedure.
- Patients demonstrated recovery from sepsis and clinical improvement.
Implications:
- Exchange blood transfusion is a beneficial therapeutic option for pediatric patients with sepsis after open heart surgery.
- The use of irradiated and dialysed blood may enhance stability, even with high-dose catecholamine support.
- This technique offers a stable circulatory environment for critically ill pediatric surgical patients.
Abstract:
We experienced 2 cases of septic children after open heart surgery. Both of them recovered by using exchange blood transfusion technique. We use irradiated and dialysed fresh blood for exchange blood transfusion. After this procedure, they recovered from sepsis, as the datas improving, white blood cell reduced from 19,700 +/- 3,710 to 8,200 +/- 2,360, CRP reduced from 5.46 +/- 1.65 to 1.89 +/- 0.70, T-Bil reduced from 7.61 +/- 2.66 to 3.02 +/- 0.89, and BUN reduced from 525.92 +/- 6.64 to 19.76 +/- 5.34. Furthermore, blood pressure and urine volume were stable between exchange blood transfusion, although after open heart surgery. Therefore this procedure has benefits for the compromised, septic patients, performed open heart surgery, because of its stability of the circulating circumstances. And using the irradiated and dialysed fresh blood provides stable condition eventhough under high dose catecholamine use.