Exchange transfusion for neonatal jaundice

2001 ◽  
Author(s):  
John F. Mills ◽  
Paul G Woodgate
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice

scholarly journals Risk factors and outcome of neonatal jaundice in a tertiary hospital

1970 ◽  
Vol 4 (2) ◽  
pp. 70-73 ◽  
Author(s):  
Bedowra Zabeen ◽  
Jebun Nahar ◽  
N Nabi ◽  
A Baki ◽  
S Tayyeb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
G6pd Deficiency ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Complete Blood Count ◽  
Birth Asphyxia ◽  
Tertiary Hospital ◽  
Thyroid Stimulating Hormone ◽  
History Of

Neonatal jaundice is a common cause of newborn hospital admission. The risk factors, the characteristics and outcomes related to neonatal jaundice in Bangladesh has not been studied so far. This study addressed the outcomes, characteristics and risks of the jaundiced newborn admitted into hospital. The babies who had significant jaundice and required phototherapy and /or exchange transfusion were investigated. A detailed history of delivery with gestational age was noted and clinical examination of the admitted newborn was done. Birth weight was recorded. The investigations included complete blood count, ABO and Rh compatibility, serum bilirubin, glucose 6 phosphate dehydrogenase (G6PD), thyroid stimulating hormone (TSH) and ultrasonography (USG) of brain. The newborns were closely monitored for the prognosis. The requirement of individualized phototherapy and exchange transfusion were also noted. Finally, the outcomes were recorded. Overall, 60 (m v. f = 58.3 v. 41.7%) newborns were found who developed significant jaundice and were investigated. Of them, 35% had gestational age less than 32wks and only 32% had equal to or greater than 35wks. Regarding delivery, 83.3 % had the history of caesarean section. ABO- and Rh– incompatibilities were found in 13.3% and 3.3%, respectively. Septicemia was diagnosed among 26.7% though blood culture yielded growth only in 20%. Compared with the higher gestational age-group (? 35 wks) the lower group (<32 wks) showed significantly higher rate of septicemia (12.5 v. 68.8%, p<0.005). G6PD deficiency was found in only one (1.7%) case. Birth asphyxia was found as a concomitant factor in three patients. Exchange transfusion was done only in 2 (3.3%) babies. Among them one was preterm IDM with septicemia and other had G6PD deficiency. None of these babies developed kernicterus. Five (8.3%) babies died, all of them had septicemia and one baby also had intraventricular hemorrhage (IVH) with PDA. The study revealed that a substantial number of neonatal jaundice had the history of lower gestational age in Bangladeshi newborns; and the lower gestational age is significantly associated with septicemia and possibly with hyperbilirubinemia. More study is needed to establish the study findings. DOI: 10.3329/imcj.v4i2.6500Ibrahim Med. Coll. J. 2010; 4(2): 70-73

Evaluation of the Severity and Duration of Thrombocytopenia following Exchange Transfusion in neonatal hyperbilirubinemia

2019 ◽  
Author(s):  
Hassan Boskabadi ◽  
Mahdie Mir
Keyword(s):  
Platelet Count ◽  
Cross Section ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Month Of Birth ◽  
Recommended Treatment ◽  
Common Causes ◽  
Abnormal Increase ◽  
The Mean ◽  
Convenience Sampling

Background: Infant jaundice is one the most common causes of hospitalization in infant in the first month of birth, which is defined an abnormal increase in blood bilirubin levels. Exchange transfusion is the recommended treatment for neonatal jaundice who do not respond to phototherapy and experience dangerous complication of jaundice and signs of kernicterus. However, this treatment may lead to complications such as thrombocytopenia. This study aimed to investigate the severity and duration of thrombocytopenia following the exchange transfusion in neonatal jaundice. Material and Methods: This cross section study was performed on 217 infants. Infants with a gestational age of 35 to 42 weeks and bilirubin levels of above 17 mg/dl, who were undergoing treated with exchange transfusion, entered in this study. This study was conducted from 2012 to 2018 in the Ghaem Hospital (Mashhad, Iran). The samples were selected by convenience sampling. The platelet count was measured before exchange transfusion, right after exchange transfusion, 6 hours after exchange transfusion, and platelet count continued until platelet level was normal.  At the time of discharge, platelet levels were re-measured. Results: Among the samples, 104(53.8%) were males and 89 (46.2%) females. Of the infants who were transfused, 15 % had thrombocytopenia. After the exchange transfusion, 80 % of infants had thrombocytopenia. The mean platelet count before the exchange transfusion was 299,180 per mm3 of blood, and it was 105.140 per mm3 of blood after the exchange transfusion. With respect to severity of this complication, 86 % of the thrombocytopenia after exchange transfusion was mild to moderate. Conclusion: In this study, nearly one-sixth of the infants who needed exchange transfusions had thrombocytopenia that most of them had platelet of more than 100000.  Thrombocytopenia is associated with jaundice and can be exacerbated by phototherapy.

scholarly journals Neonatal jaundice causes and management

2018 ◽  
Vol 5 (11) ◽  
pp. 4992
Author(s):  
Ruya Althomali ◽  
Renad Aloqayli ◽  
Basma Alyafi ◽  
Ahela Nono ◽  
Suhaib Alkhalaf ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Intravenous Immunoglobulins ◽  
Pharmacological Agents ◽  
Abo Incompatibility ◽  
Search Terms ◽  
Bilirubin Metabolism ◽  
Comprehensive Search ◽  
Neonates And Infants

80% of healthy neonates present with some degree of hyperbilirubinemia after birth, however, only 5-10% would require therapy to prevent damage or treat the cause of jaundice. Neonatal jaundice can be classified as physiological and pathological and can have several causes such as breast milk feeding, blood group incompatibility, hemolysis, or genetic defects of enzymes in the bilirubin metabolism pathway. We tried to understand the various types of neonatal jaundice, and also focus on its management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 2001 to March 2017. The following search terms were used: neonatal jaundice, hyperbilirubinemia, ABO incompatibility, neonatal hemolysis, kernicterus, phototherapy, exchange transfusion. Hyperbilirubinemia and jaundice are common issues encountered neonates and infants. Most cases of neonatal hyperbilirubinemia and jaundice are physiological and benign. However, some severe cases may progress to develop severe and permanent long-term complications. Therefore, early diagnosis and management is essential. Neonatal jaundice can be treated using phototherapy, pharmacological agents, intravenous immunoglobulins and exchange transfusion in severe cases.

Frequency of Hypocalcemia with Exchange Transfusion in Neonatal Jaundice

2021 ◽  
Vol 15 (8) ◽  
pp. 1849-1851
Author(s):  
Ambreen Ali ◽  
Ashfaq Ahmad Shah Bukhari ◽  
Shameela Majeed ◽  
Saira Gul ◽  
Nomana Khalil ◽  
...  
Keyword(s):  
Serum Level ◽  
Study Design ◽  
Selection Criteria ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional

Aim: To determine the frequency of hypocalcemia with exchange transfusion in neonatal jaundice. Study design: Descriptive cross-sectional study Place and duration of study: Departments of Pediatrics and Pathology, Naseer Teaching Hospital Peshawar from 1stJanuary 2018 to 31st December 2018. Methodology: One hundred and sixty twopatients of jaundiced neonates having total serum bilirubin >20mg/dl, both gender and patients having age up to 14 days were included. Patients fulfilling the selection criteria had undergone exchange transfusion. Hypocalcaemia was evaluated and considered positive if calcium serum level is <8 mg/dl or <2 mmol/L. Results: 50% of neonates were between 1-5 days, 45% of neonates were between 5-10 days, and 3% of neonates were in age 10-14 days. One hundred and ten (68%) of neonates were males and 52 (32%) of neonates were females. 30% neonates had hypocalcemia while 70% were without hypocalcemia. Conclusion: The incidence of hypocalcemia was found to be 30% with exchange transfusion in neonatal jaundice. Keywords: Hypocalcemia, Exchange transfusion, Neonatal jaundice

scholarly journals Causes, Management and Immediate Complications of Management of Neonatal Jaundice ? A Hospital-Based Study

2015 ◽  
Vol 5 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Mahmud Hossain ◽  
Momotaj Begum ◽  
Shafi Ahmed ◽  
Md Nurul Absar
Keyword(s):  
Birth Weight ◽  
Negative Correlation ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Chi Square ◽  
College Hospital ◽  
Medical College ◽  
Rh Incompatibility ◽  
Severe Jaundice

Background: Jaundice is very common in the neonatal period of life. Although it is not a major cause of mortality, it is an important cause of morbidity. So, assessment of the causes and risk factors of neonatal jaundice is very important.Objectives: The objectives of the study were to find out the causes of jaundice, its clinical features, evaluation of the outcome of current management strategy and complications encountered by the participating subjects following treatment.Materials and Methods: This prospective study was conducted in the Neonatal Unit of Rangpur Medical College Hospital (RpMCH) during July to December 2006. A total of 100 neonates having jaundice on admission or who developed jaundice following admission were included in the study. A number of investigations were done for the purpose of assessment of neonates and their icteric condition. The test statistics used to analyse the data were descriptive statistics, Chi-square (?2) and correlation tests.Results: In the present study the median age of the jaundiced newborns on admission was 5 days, while the median age of appearance of jaundice was 3.5 days. Most of the newborns exhibited jaundice 24 hours after birth and peaked by 3–4 days. Majority of the subjects (77%) had pathological jaundice and only 23% had physiological jaundice. This study shows septicemia was in 28% cases followed by asphyxia (20%), prematurity (18%), Rh incompatibility (15%), IUGR (11%) etc. Half of the newborns (51%) had serum bilirubin (indirect) >10 mg/dL. Gestational age and serum bilirubin was found to exhibit a negative correlation. Preterm babies also tend to develop severe to very severe jaundice more than their term counterparts (p<0.001). Birth weight was also found to bear a negative correlation with serum bilirubin. Low birth weight (LBW) babies also had a significantly higher tendency to develop severe to very severe jaundice (p<0.001). Of the 77 patients who were treated, about 64% received phototherapy, 61% received antibiotics and very few (5.2%) received exchange transfusion. Majority of the patients developed some sorts of complications. The predominant complications of phototherapy were irritability (40.8%) followed by skin rashes (26.5%), loose motion (20.4%) and dehydration (16.3%). Very few newborns (4%) had hyperthermia. All four babies who received exchange transfusion suffered from hypovolaemia, one developed hypoglycaemia and one exhibited anaemia.Conclusion: Neonatal jaundice is a leading cause of hospitalisation in the first few weeks of life throughout the world. Though management of unconjugated hyperbilirubinaemia in newborns has undergone changes based on emerging evidences, phototherapy and exchange blood transfusion are still the most commonly used effective modalities for lowering serum bilirubin level.J Enam Med Col 2015; 5(2): 104-109

scholarly journals Cord blood albumin as a predictor of neonatal hyperbilirubinemia in healthy neonates

2017 ◽  
Vol 4 (2) ◽  
pp. 503 ◽  
Author(s):  
Gaurav Aiyappa K. C. ◽  
Ashvij Shriyan ◽  
Bharath Raj
Keyword(s):  
At Risk ◽  
Risk Factor ◽  
Prospective Study ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Neonatal Hyperbilirubinemia ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Background: Neonatal jaundice or icterus neonatrum has been observed in newborn babies for many centuries. The objective of this study was to determine the correlation between cord albumin levels and development of hyperbilirubinemia in term healthy neonates.Methods: A prospective study was conducted on 165 term healthy neonates. Gender, gestational age, anthropometric measurements were taken into consideration. It was ascertained that there was no other risk factor for hyperbilirubinemia amongst the neonates. The neonates were divided into two groups A and B based on the cord albumin levels of <2.8 gm/dl and >2.8 gm/dl.Results: Of the 165 babies included in the study, 126 babies were under Group 1 and 39 under Group 2. 44 babies (34%) in group 1 and 28 babies (71.7%) in group 2 (p<0.0005) developed clinical icterus of which 16 in group 1 and 19 in group 2 required phototherapy (p<0.05). 1 baby in group required exchange transfusion. The sensitivity and specificity of cord albumin in detecting neonatal hyperbilirubinemia in this study was determined to be 71.8% and 65.1% respectively.Conclusions: Cord albumin levels help to determine and predict the possibility of hyperbilirubinemia among neonates. Hence this can help to identify the at-risk neonates. So, routine determination of cord albumin can be advocated to keep a track on at risk neonates.

scholarly journals Outcome of neonatal jaundice in term neonates with ABO incompatibility at tertiary level center

2020 ◽  
Vol 7 (10) ◽  
pp. 1973
Author(s):  
Amit Kumar Thakur ◽  
Mohammad Ashfaque Ansari ◽  
Atindra Mishra ◽  
Saroj Kumar Jha
Keyword(s):  
Positive Result ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Serum Bilirubin Level ◽  
Cross Sectional ◽  
Haemolytic Disease ◽  
Term Neonates ◽  
True Incidence ◽  
New Born ◽  
Abo Incompatibility

Background: Neonatal jaundice is extremely common as almost every new-born develops an unconjugated serum bilirubin level of more than 1.8 mg/dl during the first seven days of life. ABO incompatibility is associated in about 20% of all pregnancies but manifestations of ABO haemolytic disease of new-born occurs in <10% of these cases. True incidence of ABO incompatibility, particularly in developing countries like Nepal, is not understood sufficiently. Furthermore, the confirmation of severe ABO incompatibility cannot be made accurately using only a single test. Hence, this study was done to know the outcome of jaundice in ABO incompatibility patients.Methods: This was a descriptive cross-sectional study done at Department of Paediatrics, between August 2018 to July 2019. All term neonates born to ‘O’ positive mother, with blood group A or B positive, and fulfilling the selection criteria were included in the study. Sample size was calculated to be 114 with confidence level at 95% and prevalence of ABO haemolytic disease as 11.4% with margin of error 5%.Results: Severe ABO incompatibility as evident by presence of jaundice within 24 hours of life, a positive result on direct coomb’s test and haemolytic picture on peripheral blood smear was observed in 12% of the total enrolled 200 neonates. Modalities of treatment showed significant relation with severe ABO incompatibility indicating increased need for double volume exchange transfusion in neonates with severe ABO incompatibility.Conclusions: Phototherapy was found to be effective in the management of most of the cases of neonatal jaundice in term ABO incompatible neonates but some cases, requiring exchange transfusion can occur, mostly in presence of positive result on direct Coomb’s test.

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