Westmead International Network for Neonatal Education and Research (WINNER) Institute, Centre for Newborn Care, Westmead Hospital, University of Sydney, Hawkesbury Road, New South Wales 2145, Australia.
Clin Perinatol. 2010 Jun;37(2):481-99. doi: 10.1016/j.clp.2009.12.002.
Because of inadequate sample sizes of randomized controlled trials, few immunologic interventions to treat or prevent neonatal sepsis have been reliably evaluated. International collaboration is essential in achieving timely, adequate samples to assess effects on mortality or disability-free survival reliably. Promising or possible therapeutic interventions in severe or gram-negative sepsis include exchange transfusions, pentoxifylline, and IgM-enriched intravenous immunoglobulin. Promising or possible prophylactic interventions include lactoferrin, with or without a probiotic; selenium; early curtailment of antibiotics after sterile cultures; breast milk; and earlier initiation of colostrum in high risk preterm infants. Prophylactic oral probiotics are safe and effective (P<.00001) in reducing all-cause mortality and necrotizing enterocolitis in preterm infants by over half, but do not reduce sepsis.
由于随机对照试验的样本量不足，很少有免疫干预措施被可靠地评估用于治疗或预防新生儿败血症。国际合作对于及时获得足够的样本以可靠地评估对死亡率或无残疾生存的影响至关重要。在严重或革兰氏阴性败血症中，有前途或可能的治疗干预措施包括换血、己酮可可碱和富含 IgM 的静脉免疫球蛋白。有前途或可能的预防干预措施包括乳铁蛋白，联合或不联合益生菌；硒；无菌培养后抗生素的早期限制使用；母乳；高危早产儿中更早开始初乳。预防性口服益生菌对半降低早产儿的全因死亡率和坏死性小肠结肠炎的效果安全且有效（P<.00001），但不能降低败血症的发生率。
