Dalldorf Katherine, Juliano Courtney, Dawa Tenzin, Ratner Veniamin, Tiozzo Caterina
Division of Neonatology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States.
CT Operating Room Clin Personnel, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States.
Front Pediatr. 2025 May 21;13:1570946. doi: 10.3389/fped.2025.1570946. eCollection 2025.
Extracorporeal membrane oxygenation (ECMO) related hemolysis is a severe complication seen frequently in neonates requiring ECMO support. While circuit exchange is a common management approach, it carries the risk of hemodynamic instability due to the inflammatory reaction triggered by exposure to a new circuit. We present the case of a newborn with remarkably elevated bilirubin levels that persisted despite circuit changes and responded to a double volume exchange transfusion (DVET) while under extracorporeal life support (ELS). This is the first reported occurrence of a DVET performed on a newborn with severe hemolysis while on veno-arterial ELS and only the second documented case in a pediatric patient. Our aim is to underscore the feasibility and safety of utilizing DVET for newborns undergoing ELS. This procedure serves as an alternative or adjunct approach to circuit replacement for the management of severe hemolysis and associated hyperbilirubinemia.
体外膜肺氧合（ECMO）相关的溶血是需要ECMO支持的新生儿中常见的严重并发症。虽然更换循环管路是一种常见的处理方法，但由于接触新的循环管路引发炎症反应，存在血流动力学不稳定的风险。我们报告了一例新生儿，其胆红素水平显著升高，尽管更换了循环管路仍持续不降，在体外生命支持（ELS）期间对双倍容量交换输血（DVET）有反应。这是首次报道在接受静脉-动脉ELS的严重溶血新生儿中进行DVET，也是儿科患者中第二例有记录的病例。我们的目的是强调对接受ELS的新生儿使用DVET的可行性和安全性。该 procedure可作为更换循环管路的替代或辅助方法，用于治疗严重溶血及相关的高胆红素血症。 （注：原文中“procedure”未明确指出具体是什么，译文保留原文表述。）
