Albumin administration in exchange transfusion for hyperbilirubinaemia.

Comley, Ann; Wood, B. S. B.

doi:10.1136/adc.43.228.151

Cited by 31 publications

(12 citation statements)

References 17 publications

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“…However, the additional bilirubin production after the ET caused by the P-haemoglobin would be com pensated for by the excess of albumin in the frozen blood. This addition of albumin would increase the bilirubin elimination during the ETs by about 25% [7] as well as increase the bilirubin-binding capacity of the plasma following ETs with frozen blood as revealed by the HBABA values.…”

Section: Discussionmentioning

confidence: 99%

Exchange Transfusions with Frozen Blood

Kreuger¹

1976

Vox Sanguinis

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On 15 newborn infants, 31 exchange transfusions were performed, 11 with previously frozen red blood cells resuspended in albumin-electrolyteglucose solution, 4 with previously frozen red blood cells resuspended in fresh frozen plasma and 16 with ACD blood. Good clinical effects were obtained in all cases and no untoward clinical reactions were noticed. More pronounced decreases in vB pH and vB standard bicarbonate were noted after exchange transfusions with frozen blood than after ACD blood transfusions. Small and unimportant changes of plasma electrolytes were recorded following exchange transfusions with frozen blood. The P-haemoglobin concentrations were higher in the frozen blood than in the ACD blood, resulting in an increase of P-haemoglobin following exchange transfusion with frozen blood. The wash-out effect of the frozen blood was indicated by a reduction of platelets, fibrinogen and IgG during the exchange transfusions to 20% of the original value. Furthermore, a decrease in coagulation capacity was observed as revealed by considerable changes in TT and APTT values. For newborn infants with suspected or manifest coagulation disorders and for newborn infants needing more than one exchange transfusion, frozen, thawed and washed red blood cells should be resuspended in fresh or fresh frozen plasma when used as transfusion blood.

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Section: Discussionmentioning

confidence: 99%

Exchange Transfusions with Frozen Blood

Kreuger¹

1976

Vox Sanguinis

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“…Albumin has been used to raise the serum albumin level in premature babies (Odell, 1959a), and in association with exchange transfusion to increase bilirubin removal (Kitchen, Krieger, and Smith, 1960;Odell, Cohen, and Gordes, 1962;Comley and Wood, 1968). In situations where the neonate is admitted with high serum bilirubin level and when blood is not readily available for exchange transfusion, albumin may offer protection against kernicterus, and may even extract bilirubin which has already diffused into the tissues (Diamond and Schmid, 1966).…”

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confidence: 99%

Albumin in Management of Neonatal Hyperbilirubinaemia

Tsao¹,

Yu²

1972

Archives of Disease in Childhood

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1972). Archives of Disease in Childhood, 47, 250. Albumin in management of neonatal hyperbilirubinaemia. The effect of albumin priming on the plasma volume, intravascular bilirubin, and HBABAbinding capacity during the subsequent 2 to 4j hours before exchange transfusion was studied in 7 jaundiced neonates with no haemolytic disease. After priming with albumin at a dose of 1 -75 g/kg body weight as a 10% solution, there was a marked increase in plasma volume as well as total intravascular bilirubin and HBABAbinding capacity. However, the serum bilirubin concentration fluctuated only very slightly, largely because of the dilution effect of the expanded plasma volume. Both albumin and bilirubin gradually diffused out of the intravascular compartment again, but at the end of the observation period there was still a net gain of both.In another 20 neonates, the efficiency of exchange transfusion in removing bilirubin was compared. The efficiency was decreased by early albumin priming and enhanced by enriching the donor's blood with albumin.It is concluded that albumin offers immediate and short-term protection against bilirubin toxicity, and albumin-priming should be useful in situations where the babies are admitted with high bilirubin levels and blood is not immediately available for exchange transfusion. Because of its effect on the plasma volume, albumin is not recommended for babies who are already hypervolaemic. If albumin is used to increase the efficiency of exchange transfusion, it should be given together with donor's blood or shortly before the procedure.

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“…It has been shown that administration of intravenous albumin raises the intravascular fraction of bilirubin (Odell, 1959a and b) and that albuminenriched exchange transfusion increases the plasma's capacity to hold bilirubin within the extracellular space (Kitchen, Krieger, and Smith, 1960;Odell, Cohen, and Gordes, 1962;Waters and Porter, 1964;Sproul and Smith, 1964;Comley and Wood, 1968) and may decrease the risk of cellular damage (Wood, Comley, and Sherwell, 1970). Since phototherapy was introduced (Cremer, Perryman, and Richards, 1958), it has been shown to lower plasma bilirubin levels in neonatal jaundice (Broughton et al, 1965;Lucey, Ferreiro, and Hewitt, 1968).…”

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confidence: 99%

Effect of Albumin Administration on Phototherapy for Neonatal Jaundice

Wong¹,

Shuttleworth²,

Wood³

1972

Archives of Disease in Childhood

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. Effect of albumin administration on phototherapy for neonatal jaundice. Two clinical trials were designed to test the effect of albumin administration before phototherapy for non-haemolytic neonatal jaundice. The first with 18 hours of phototherapy showed that the albumin-treated group (23 infants) had higher and more prolonged jaundice than the group (27 infants) given phototherapy alone.In the second study on 29 infants there were two groups as before, but the duration of phototherapy was increased to at least 48 hours and a third untreated group was included. These results showed significant differences between all three groups, the cases receiving phototherapy alone having the shortest and those receiving no specific therapy, the longest duration of jaundice.Those patients given albumin intravenously had significantly greater albuminbinding capacity at the end of treatment.It has been shown that administration of intravenous albumin raises the intravascular fraction of bilirubin (Odell, 1959a and b) (Wood, Comley, and Sherwell, 1970). Since phototherapy was introduced (Cremer, Perryman, and Richards, 1958), it has been shown to lower plasma bilirubin levels in neonatal jaundice (Broughton et al., 1965;Lucey, Ferreiro, and Hewitt, 1968).The present study was planned to observe the effect of albumin administered intravenously before phototherapy. It was also hoped to discover whether the light acted on the extravascular or intravascular component of bilirubin mass; thus, if light breaks down bilirubin in the extravascular space, then administration of albumin should decrease its effect by withdrawing bilirubin into the intravascular component. Conversely, administration of albumin should enhance the effect of phototherapy if it destroys the bilirubin circulating in the blood stream.

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Albumin administration in exchange transfusion for hyperbilirubinaemia.

Cited by 31 publications

References 17 publications

Exchange Transfusions with Frozen Blood

Exchange Transfusions with Frozen Blood

Albumin in Management of Neonatal Hyperbilirubinaemia

Effect of Albumin Administration on Phototherapy for Neonatal Jaundice

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