Neonatal Sepsis and the Use of Extracorporeal Therapy Methods: A Clinical Case
Main Article Content
Abstract
Neonatal sepsis remains one of the leading causes of mortality in newborns. Limited data on the use of extracorporeal blood purification in this population highlight the need for further clinical observations. This article presents the first successful case in Kazakhstan of hemofiltration use in a neonate with sepsis caused by Klebsiella pneumonia ESBL 107 CFU/ml. We report the clinical course of a newborn with congenital malformations and early neonatal sepsis caused by Klebsiella pneumonia ESBL (10⁷ CFU/ml). Continuous veno-venous hemofiltration (CVVH) using an ST60 pediatric hemofilter was performed in the intensive care unit. Monitoring included hemodynamic assessment, laboratory inflammatory markers, coagulation profile, urine output, and acid–base balance. CVVH led to stabilization of hemodynamics, reduction in lactate levels (from 4.5 to 1.6 mmol/L), normalization of diuresis, decrease in inflammatory markers (CRP from 297 to 19 mg/L; procalcitonin from 24.7 to 1.1 ng/mL), and platelet recovery (from 11 to 93×10⁹/L). Vasopressor doses were reduced, enabling reconstructive surgery. The patient was successfully extubated and transferred to a specialized ward. This clinical case demonstrates the effectiveness and relative safety of hemofiltration in neonates with sepsis and MODS. The method may be considered a promising therapeutic option when standard treatment fails, underscoring the need for further multicenter studies.
Article Details
Accepted 2025-12-18
Published 2025-12-18
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