The Turkish Journal of Pediatrics
2010 , Vol 52 , Num 4
Exchange transfusion in severe hyperbilirubinemia: an experience in northwest Iran
Tabriz University, Medical Science, Tabriz, Iran
Our goal was to determine the indications for exchange transfusion (ECT)
and the rates of ECT-related adverse events in neonatal hyperbilirubinemia.
We reviewed retrospectively the medical charts of all newborns that had
undergone ECT over three years from January 2006 to December 2008. Causes
of jaundice, demographic data of the patients, and details of ECT and ECTrelated
adverse events were recorded. A total of 176 ECT procedures were
performed in 150 neonates in the three-year study period. The mean total
serum bilirubin before ECT was 29.59±6.88 mg/dl. Those infants requiring
more than one ECT had higher total serum bilirubin than neonates with
single ECT, but the difference was not significant (35.66±12.21 vs. 29.12±6.30
mg/dl, p=0.09). The most common cause of ECT was ABO incompatibility
(49.3%), Rh disease (7.3%) and idiopathic (28%). Among the adverse events
related to ECT, thrombocytopenia (36.4%), hypocalcemia (25.5%), apnea
(20%), and infection (10.9%) were noted commonly. No case of ECT-related
mortality was observed. All of the adverse events resolved completely before
discharge. ABO isoimmunization was the most common cause of ECT in this
study. The majority of adverse events associated with ECT are asymptomatic
and reversible.
Keywords :
hyperbilirubinemia, neonate, exchange transfusion, complication,
indication.