Study of 25 cases of exchange transfusion by reconstituted blood in hemolytic disease of newborn

Two well-known authorities on hemolytic disease undertake in this paper to determine the causes for what they consider to be an excessive mortality from this disease in England and Wales at the present time. They state that with correct use of exchange transfusion a mortality of not more than 5% of infants with hemolytic disease born alive should be expected. The authors express the opinion that the deaths at present are at least three times as numerous as should be expected with modern treatment. Analysis of the reported deaths seem to indicate two principal causes for this: (1) failure to anticipate the disease before birth or to recognize the disease early after birth, and (2) either failure to undertake an exchange transfusion or to employ satisfactory technique in the exchange transfusion, particularly to give an adequate exchange. They point out that the best results are to be expected in hospitals where a large number of cases are treated and considerable experience is acquired. In hospitals where the number of cases seen is small it is difficult for the staff to gain the necessary experience and familiarity with the technique of exchange transfusion and the general principles of diagnosis and management. A full discussion of the essential points in prediction and diagnosis of the disorder and of the indications for exchange transfusion, with emphasis on the volumes of blood to be exchanged, are given.

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ADDENDUM

PEDIATRICS ◽

10.1542/peds.4.2.265a ◽

1949 ◽

Vol 4 (2) ◽

pp. 265-265

Keyword(s):

Exchange Transfusion ◽

Hemolytic Disease

Mitchell, N., et al., Congenital hemolytic disease resulting from A-O isoimmunization, Pediatrics 3:813, 1949. The mother in Case 2 has been delivered of another child just a few weeks ago. The infant was born with jaundice and on the second day of life an exchange transfusion was carried out with apparently good results. The infant is at present alive and healthy. Line 21 on page 818 should read "present three cases" instead of "two fatal cases."

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Letter to the Editor

PEDIATRICS ◽

10.1542/peds.50.1.165 ◽

1972 ◽

Vol 50 (1) ◽

pp. 165-165

Author(s):

Philip Lanzkowsky

Keyword(s):

Exchange Transfusion ◽

Hemolytic Disease ◽

Splenic Sequestration ◽

Multiple Factors ◽

Letter To The Editor

I regret that Dr. Ente has misunderstood both the content and the intent of our paper. We never stated that anemia in hemolytic disease is the fault of phototherapy, but stated that it was the consequence of multiple factors such as transient erythroblastopenia, splenic sequestration, and continuous hemolysis, and was well recognized before the use of phototherapy. The intent of the paper was, not to blame the therapy, but to caution the physican about the need to do frequent bilirubin and hemoglobin estimations in hemolytic disease of the newborn, especially when the infant has had phototherapy and therefore may not require an exchange transfusion.

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HEMOLYTIC DISEASE OF THE NEWBORN DUE TO ABO INCOMPATIBILITY: A STUDY OF THE USE OF GROUP O ERYTHROCYTES IN AB PLASMA

PEDIATRICS ◽

10.1542/peds.34.5.664 ◽

1964 ◽

Vol 34 (5) ◽

pp. 664-669

Author(s):

Donald L. Goldfarb ◽

Victor Ginsberg ◽

Mary Kaufman ◽

Margaret G. Robinson ◽

R. Janet Watson

Keyword(s):

Exchange Transfusion ◽

Conventional Group ◽

Hemolytic Disease ◽

Abo Incompatibility

Twenty-four infants with hemolytic disease of the newborn due to ABO incompatibility requiring exchange transfusion were treated randomly with either group O blood low in titer for iso-antibodies or washed packed group O erythrocytes resuspended in group AB plasma. No significant differences in survival, sequelae, number of exchange transfusions required or the course of postexchange bilirubin levels was observed. It is concluded that group O cells in AB plasma is not an improvement over conventional group O blood.

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Technique for Exchange Transfusion

PEDIATRICS ◽

10.1542/peds.17.3.449 ◽

1956 ◽

Vol 17 (3) ◽

pp. 449-449

Keyword(s):

Exchange Transfusion ◽

Hemolytic Disease ◽

Mortality And Morbidity

Exchange transfusions in hemolytic disease of the newborn are now generally accepted as the proper procedure for reducing the mortality and morbidity of this entity. It is our experience that more and more hospitals with active newborn services are carrying out this procedure themselves rather than transferring the patient to pediatric centers. For this reason the technique should be standardized and simplified as much as possible.

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