Double Volume Exchange Transfusion in Severe Neonatal Sepsis

Indian J Pediatr. 2016 Feb;83(2):107-13. doi: 10.1007/s12098-015-1841-0. Epub 2015 Jul 28.


Objectives: To study the efficacy and safety of double volume exchange transfusion (DVET) in neonates > 1000 g birth weight with severe sepsis.

Methods: Eighty-three neonates weighing >1000 g with severe sepsis were randomly assigned to DVET or standard therapy (ST) group. Primary outcome was mortality by 14 d from enrollment.

Results: A 21 % reduction in mortality, albeit non-significant, by 14 d from enrollment was observed in DVET group in comparison to ST group [RR: 0.79 (95 % C.I 0.45-1.3); p 0.4]. A similar trend in mortality reduction was observed with early mortality and mortality by discharge in DVET group. No difference was observed in normalization of dysfunctional organs by 14 d. Cardiovascular and hematological system benefitted the most, followed by renal dysfunction with DVET. A significant improvement in post DVET IgG, IgA, IgM, C3 and base deficit was observed. No serious adverse effects occurred following DVET.

Conclusions: In neonates >1000 g with severe sepsis, DVET was associated with a trend towards decrease in mortality by 14 d from enrollment. A significant improvement in immunoglobulin and complement C3 levels and acid base status were observed following DVET. DVET is a safe procedure in severely sick and septic neonates.

Keywords: Double volume exchange transfusion; Mortality; Neonate; Organ dysfunction; Severe sepsis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Exchange Transfusion, Whole Blood* / methods
  • Exchange Transfusion, Whole Blood* / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Multiple Organ Failure* / diagnosis
  • Multiple Organ Failure* / etiology
  • Multiple Organ Failure* / prevention & control
  • Neonatal Sepsis* / complications
  • Neonatal Sepsis* / diagnosis
  • Neonatal Sepsis* / mortality
  • Neonatal Sepsis* / therapy
  • Organ Dysfunction Scores
  • Sepsis* / complications
  • Sepsis* / diagnosis
  • Sepsis* / therapy
  • Survival Analysis
  • Treatment Outcome