Exchange transfusion as an alternative to granulocyte concentrate administration in neonates with bacterial sepsis and profound neutropenia
✍ Scribed by Dr. Robert D. Christensen; Harry R. Hill; Harold B. Anstall; Gerald Rothstein
- Publisher
- John Wiley and Sons
- Year
- 1984
- Tongue
- English
- Weight
- 608 KB
- Volume
- 2
- Category
- Article
- ISSN
- 0733-2459
No coin nor oath required. For personal study only.
✦ Synopsis
A high rate of mortality is observed in the subset of neonates with early-onset bacterial sepsis who develop profound neutropenia and depletion of the marrow neutrophil reserve. Several studies suggest that tr.anhfir\ion of apheresis-collected adult neutrophils into such subjects can be beneficial. yet inherent delays in preparation of neutrophil concentrates can limit their clinical utility. In six neonates with sepsis and profound neutropenia. we performed double-volume exchange transfusions using freshly drawn donor blood and determined that a net gain of 0.3-0.7 x 10' neutrophils/kg body weight had occurred. The blood neutrophil count of the patients increased from 220 to I ,660/nim3 beforc the transfusion to 1,650-5, 140/nim3 immediately afterward. We ncxt attempted to further incrcase the number of neutrophils delivered by exchange transfusion by subjecting blood donors to 2 niin of physical exercise in order to induce neutrophilia. After such exercise, 30% (range 18-55%) more neutrophils were harvested. The metabolic burst activity and in vitro migration of neutrophils after exercise did not differ from paired prcexercise values.