To determine the role of polymorphonuclear (PMN) leukocyte transfusions in neonates with sepsis, 23 consecutive newborns were prospectively randomly selected during an 18-month period in a treatment Plan to receive polymorphonuclear leukocyte transfusions with supportive care or supportive care alone. Thirteen neonates received transfusions every 12 hours for a total of five transfusions. Each transfusion consisting of 15 mL/kg of polymorphonuclear leukocytes was subjected to 1,500 rads of radiation. The polymorphonuclear leukocytes were obtained by continuous-flow centrifugation leukapheresis and contained 0.5 to 1.0 x 109 granulocytes per 15 mL with less than 10% lymphocytes. Pretreatment demographic, clinical, and laboratory variables that were found to be insignificant in prognosis between newborns who received transfusions and newborns who did not receive transfusions included weight, gestational and postnatal age, hypoxia, acidosis, hypotension, initial absolute granulocyte count (AGC), initial levels of immunoglobulins (IgA, IgG, and IgM), and total hemolytic complement. Positive findings on blood cultures were obtained in 14/23 patients and even were randomly selected for each treatment group. Absolute granulocyte counts were 1,500/μL in 13 patients but tibial bone marrow examinations revealed that the neutrophil supply pool was depleted in only three patients. The survival was significantly greater in the treatment group (13/13, 100%) compared with the group that did not receive transfusions (6/10, 60%, P .02). There were no unto-ward effects attributable to the polymorphonuclear leukocyte transfusions during the study or on subsequent follow-up clinic visits. These preliminary data suggest that the use of adult donor polymorphonuclear leukocytes in the early treatment of proven or clinically suspected newborns with sepsis lowers mortality of neonatal sepsis.
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机译：为了确定多形核白细胞（PMN）输血在败血症新生儿中的作用，在一个治疗计划中，在18个月内前瞻性选择了23个连续的新生儿，接受单独的支持治疗或支持性治疗进行多形核白细胞输血。每12小时有13名新生儿接受输血，总共5次输血。每次输注由15 mL / kg的多形核白细胞组成的细胞，都要接受1500拉德的辐射。多形核白细胞通过连续流离心白细胞分离术获得，每15 mL含有0.5至1.0 x 109个粒细胞，淋巴细胞少于10％。在接受输血的新生儿与未接受输血的新生儿之间，预后的人口统计学，临床和实验室变量均无统计学意义，包括体重，妊娠和出生年龄，缺氧，酸中毒，低血压，初始绝对粒细胞计数（AGC），初始水平的免疫球蛋白（IgA，IgG和IgM）和总溶血补体。在14/23例患者中获得了血培养的阳性结果，甚至为每个治疗组随机选择。 13例患者的绝对粒细胞计数<1,500 /μL，但胫骨骨髓检查显示只有3例患者的中性粒细胞供应池被耗尽。与未接受输血的组（6 / 10，60％，P <.02）相比，治疗组的存活率（13 / 13，100％）明显更高。在研究过程中或随后的随访门诊中，没有多态核白细胞输血引起的不良反应。这些初步数据表明，在早期治疗已证实或临床怀疑患有败血症的新生儿中使用成人供体多形核白细胞可降低新生儿败血症的死亡率。
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