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新生儿和婴儿的治疗性血浆置换:小型化机器的成功应用。

Therapeutic Plasma Exchange in Neonates and Infants: Successful Use of a Miniaturized Machine.

机构信息

Nephrology, Dialysis and Transplant Unit, Department of Woman's and Child's Health, University-Hospital of Padova, Padova, Italy.

出版信息

Blood Purif. 2017;44(2):100-105. doi: 10.1159/000470827. Epub 2017 Mar 31.

Abstract

Therapeutic plasma exchange (TPE) in neonates and small infants is a treatment method at the forefront that may become a potentially life-saving procedure in a wide array of severe conditions. Indications for TPE in the pediatric population have been mainly derived from adult literature, with neonatal hyperbilirubinemia being the most notable exception. The only alternative to TPE in small pediatric patients is manual blood exchange transfusion, which, however, bears an unacceptably high risk of severe complications. Still, technical issues due to extracorporeal circulation in neonates have burdened TPE so far, since machines developed for adults require a relatively large blood volume to operate. We in this study, describe our preliminary experience of TPE for treating 2 potentially life-threatening conditions in neonatal age. To overcome the aforementioned limitations, plasmapheresis was performed in both cases using a machine specifically designed for patients weighing less than 10 kg.

摘要

治疗性血浆置换(TPE)在新生儿和小婴儿中是一种前沿的治疗方法,可能成为广泛严重疾病中潜在的救生程序。TPE 在儿科人群中的适应证主要来自成人文献,新生儿高胆红素血症是最显著的例外。在小的儿科患者中,TPE 的唯一替代方法是手动血液交换输血,但它存在不可接受的严重并发症风险。然而,由于新生儿体外循环的技术问题,TPE 至今仍存在负担,因为为成人开发的机器需要相对较大的血量才能运行。在这项研究中,我们描述了我们在新生儿期治疗 2 种潜在危及生命的疾病的 TPE 初步经验。为了克服上述限制,在这两种情况下,均使用专门为体重小于 10 公斤的患者设计的机器进行血浆分离。

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