On-Line Plasma Exchange for Sepsis in Neonates and Infants

Abstract

The present study way designed to assess the effectiveness of on-line plasma exchange (on-line P.E.) between septic infants and healthy adults using septic puppies. The plasma separation system consisted of a membrane plasma separator and a plasma treatment system, KM-9027 (Kurarey Co.) equipped with small 2 channel blood and plasma pumps. 5×109 CFU/ml/kg of E. coli with endotoxin was injected intravenously into 22 puppies and they were divided into 4 groups, namely untreated group (n = 7), on-line P.E. group (n = 5), P.E. group (n = 5), sham group (n = 5). In the on-line P.E. group, about 80 ml/kg of plasma in septic puppy was replaced during 2 hr with fresh plasma simultaneously obtained from healthy adult dog. As the results, 4 of 5 survived in the on-line P.E. group and 1 of 5 survived in the P.E. group, while all other puppies died within 24 hr. In the P.E. group and on-line P.E. group, mean blood pressure and urinary output were significantly improved (p>0.05) by the treatment. The numbers of E. coli and endotoxin concentration in the blood were reduced significantly (p>0.05) only in the treatment with on-line P.E. opsonic activity recovered significantly (>0.05) in P.E. group. This system appears to be effective and applicable for sepsis in infants and neonates. © 1989, Tohoku University Medical Press. All rights reserved.