ORIGINAL ARTICLE Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 43/ October 28, 2013 Page 8297 EXCHANGE TRANSFUSION IN NEONATAL SEPSIS DOSE NOT REDUCES OVERALL MORTALITY Uday Rajput 1 , L.S. Deshmukh 2 HOW TO CITE THIS ARTICLE: Uday Rajput, LS Deshmukh. “Exchange transfusion in neonatal sepsis dose not reduces overall mortality”. Journal of Evolution of Medical and Dental Sciences 2013; Vol. 2, Issue 43, October 28; Page: 8297-8301. ABSTRACT: OBJECTIVES: To evaluate the role of exchange transfusion in severe neonatal sepsis. DESIGN: Retrospective cohort study. SETTING: Neonatal intensive care unit of teaching hospital. SUBJECTS & METHOD: Retrospective cohort study was carried out from June 2010 to May 2011. Thirty babies who developed severe sepsis (Sclerema) and who underwent double volume exchange transfusion primarily for sepsis, were included in the study and were compared with matched controls who did not receive exchange transfusion. RESULTS: The overall mortality rate in study group was 49% as compared to 62% in the controls. However the difference was not statistically significant. The duration of hospital stay was longer in the study group (45 Vs 29 days) (p<0.001). Exchange transfusion did not make any different to the organism specific mortality. No clinically significant complications were observed with exchange transfusion. CONCLUSIONS: Exchange transfusion does not alter the mortality in the babies with severe sepsis. KEY WORDS: Sclerema, Severe sepsis, Exchange transfusion. INTRODUCTION: Neonatal sepsis is a frequent and serious event, which threatens survival during the first four weeks of life. In developing countries, public hospitals face the major burden of this problem. Public hospitals many times face the paucity of higher antibiotics, in addition, septicemia requires lot of supportive measures and intensive therapy leading to increase the length of NICU stay. All above factors add to increased neonatal care cost and poor outcome. Exchange transfusion has been tried to improve the immediate outcome in severely septicemic babies 1-9 . However, there are very few studies of role of exchange transfusion in sepsis particularly in developing countries 4. 6,7,8 . Considering the possible usefulness of exchange transfusion in severely septicemic babies, present study was undertaken. SUBJECTS AND METHODS: A retrospective cohort study was done to evaluate the role of exchange transfusion in severe neonatal sepsis at Neonatal Intensive Care Unit of Government Medical College and Hospital, Aurangabad during June 2010 to May 2011. Thirty septicemic neonates who were critically ill (Sclerema), underwent exchange transfusion. They were compared with age-matched controls, who were critically ill (Sclerema) but did not undergo exchange transfusion. Babies having clinical features of severe sepsis (sclerema), irrespective of growth on blood culture were included in the study. Babies requiring exchange transfusion for hyperbilirubinemia were excluded. A double volume exchange transfusion with cross-matched adult whole blood was done. The anticoagulant used in donor blood was CPD and was negative for HbsAg, HCV, MP, VDRL and HIV. Pre and Post Exchange blood culture, blood sugar and hemoglobin were done in each case. Vitals of babies were monitored throughout the procedure. Rest of the management was similar in