在V-A ECMO支持期间，使用Jaffron滤筒进行血液灌流成功治疗了早发性B组链球菌败血症的新生儿肝衰竭

摘要(中文译文)

引言：当常规治疗不足以应对新生儿B族链球菌（GBS）脓毒症合并多器官衰竭时，需要创新的治疗方法。病例报告：一名足月新生儿因GBS感染发生严重呼吸衰竭和感染性休克，于出生后24小时启动静脉-动脉体外膜氧合（V-A ECMO）。在ECMO支持期间，患者出现肝功能障碍伴严重高胆红素血症（总胆红素/直接胆红素峰值：36.9/31.6 mg/dL）。将Jafron HA60血液吸附柱整合入ECMO回路后，24小时内胆红素下降38%。尽管出现肺不张、肾功能障碍和院内感染COVID-19等并发症，患者仍在15天后成功撤除ECMO，24天后拔管，48天后出院回家，神经发育结局正常。讨论：本病例突出了血液吸附技术在新生儿ECMO期间管理肝功能衰竭的应用。结论：血液吸附治疗是ECMO支持期间新生儿严重高胆红素血症的一种有前景的辅助治疗方法。

Abstract

IntroductionManagement of neonatal Group B Streptococcal (GBS) sepsis with multi-organ failure requires innovative approaches when conventional therapies prove insufficient.Case ReportA term neonate developed severe respiratory failure and septic shock from GBS infection, necessitating veno-arterial extracorporeal membrane oxygenation (V-A ECMO) initiation at 24 hours of life. During ECMO support, the patient developed hepatic dysfunction with severe hyperbilirubinemia (peak total/direct bilirubin: 36.9/31.6 mg/dL). A Jafron HA60 hemoadsorption cartridge was integrated into the ECMO circuit, resulting in a 38% bilirubin reduction within 24 hours. Despite complications including lung atelectasis, renal dysfunction, and nosocomial COVID-19, the patient was successfully decannulated after 15 days, extubated after 24 days, and discharged home after 48 days with normal neurological outcomes.DiscussionThis case highlights the application of hemoadsorption technology for managing hepatic failure in neonatal ECMO.ConclusionHemoadsorption therapy represents a promising adjunctive treatment for neonates with severe hyperbilirubinemia during ECMO support.

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