Multiorganversagen bei Early-onset-B-Streptokokkensepsis: Erfolgreicher Einsatz einer kontinuierlichen venovenösen Hämofiltration (CVVH) beim Neugeborenen [Successful continuous renal replacement therapy in a neonate with early-onset group B streptococcal sepsis and multi-organ dysfunction syndrome].

Details

Serval ID
serval:BIB_0A3794D90118
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Multiorganversagen bei Early-onset-B-Streptokokkensepsis: Erfolgreicher Einsatz einer kontinuierlichen venovenösen Hämofiltration (CVVH) beim Neugeborenen [Successful continuous renal replacement therapy in a neonate with early-onset group B streptococcal sepsis and multi-organ dysfunction syndrome].
Journal
Klinische Pädiatrie
Author(s)
von Schnakenburg C., Hufnagel M., Superti-Furga A., Rieger-Fackeldey E., Berner R.
ISSN
1439-3824 (Electronic)
ISSN-L
0300-8630
Publication state
Published
Issued date
2009
Volume
221
Number
4
Pages
251-253
Language
german
Notes
Publication types: Case Reports ; English Abstract
Abstract
Background: Group B streptococcal early-onset sepsis (GBS EOS) inneonates has a mortality rate of similar to 5%, particularly in thepresence of multi-organ dysfunction. Fluid management is crucial inthese patients, and continuous venovenous haemofiltration (CVVH) shouldbe considered a therapeutic option even in newborn babies.Case report: After an uneventful pregnancy within hours after birth, afemale term infant presented with dyspnoea, irritability and cyanosis.The systemic inflammatory response syndrome (SIRS) progressed tomulti-organ dysfunction with acute respiratory distress syndrome(ARDS), impaired myocardial contractility, pulmonary hypertension andfluid overload. The maximum PRISM score was 51. The child requiredmaximal respiratory and inotropic support with high volume intravenousfluid administration. However, only by using of CVVH from day 5 to 14,we successfully resolved progressive pulmonary and cardiovasculardysfunction. The child improved directly after initiation of fluidremoval, was extubated on day 17 and discharged without obvioussequelae on day 57. All microbiology studies revealed GBS.Conclusion: Perinatal GBS-infections remain a major life-threateningevent for newborn babies. CVVH should be considered an option forreversing fluid overload even in neonates with overwhelming SIRS.Alternatively, extracorporeal membrane oxygenation (ECMO) is discussed.
Keywords
Female, Hemofiltration, Humans, Infant, Infant, Newborn, Intensive Care, Neonatal/methods, Multiple Organ Failure/diagnosis, Multiple Organ Failure/therapy, Respiratory Distress Syndrome, Adult/diagnosis, Respiratory Distress Syndrome, Adult/therapy, Sepsis/diagnosis, Sepsis/therapy, Streptococcal Infections/diagnosis, Streptococcal Infections/therapy, Streptococcus agalactiae, Systemic Inflammatory Response Syndrome/diagnosis, Systemic Inflammatory Response Syndrome/therapy
Pubmed
Web of science
Create date
14/03/2011 16:09
Last modification date
20/08/2019 12:32
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