Blood exchange transfusions in newborns, the effect on serum ionized calcium

Nelson, Nina; Finnström, Orvar

doi:10.1016/0378-3782(88)90052-7

Cited by 15 publications

(3 citation statements)

References 13 publications

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“…Thus, it appears that possibly these neonates require calcium supplementa on during the procedure to avoid the occurrence of hypocalcemia The need for giving supplemental calcium is controversial. However, if 0.5 to 1.0 ml of 10% intravenous calcium gluconate a er each 100 ml of exchange blood is used, it may reduce the incidence of hypocalcemia 18 . Thrombocytopenia (34.2%) was another major adverse event observed and the exact cause remained uncertain.…”

Section: Discussionmentioning

confidence: 99%

Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

Chitlangia

Shah

Poudel

et al. 2014

J. Nepal Paedtr. Soc.

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Introduction: Jaundice is an important problem during neonatal period. When total serum bilirubin (TSB) level exceeds a critical limit, it crosses the blood brain barrier and results into bilirubin encephalopathy. The main aim of therapy for neonatal hyperbilirubinemia is prevention of bilirubin encephalopathy by phototherapy and/or exchange transfusion. The aims of this study were to evaluate the efficacy of exchange transfusion (ET) and observe the adverse events during and following three days of ET in neonates with hyperbilirubinemia. Materials and Method: Hospital based cross-sectional descriptive study. All neonates admitted to neonatal intensive care unit and /or paediatric wards of a tertiary-care centre between September 2010 to March 2012, requiring ET were enrolled. Results: A total of 139 ETs were performed in 120 neonates. The common causes were ABO incompatibility (30.8%), prematurity (30.8%), idiopathic (27.5%), Rh isoimmunization (6.7%) and cephalhematoma (4.2%). Mean pre-ET total serum bilirubin (TSB) was 24.2 mg% dL. There was 58% reduction in TSB in post ET and 31% net reduction in 6 hr post ET. Term and preterm neonates showed equal percentage of TSB reduction. Respiratory distress (10.8%) and bradycardia (6.7%) were the common adverse events during, and hypocalcemia (98.3%) and thrombocytopenia (34.2%) in 3 days following ET. The sick neonates had significantly higher incidence of thrombocytopenia (p= 0.031), respiratory distress (p=0.009), apnea (p<0.001) and cardiorespiratory arrest (p<0.001). Overall mortality was 4.2%, and non-survivors were mostly low birth weight, born outside the present hospital and had higher incidence of adverse events. Conclusion: Exchange transfusion is an effective intervention in reducing the serum bilirubin level. However, these neonates require monitoring of ionised calcium and thrombocytopenia. Sick neonates had higher incidence of adverse events than healthy and close clinical monitoring is needed to improve the outcome.

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Section: Discussionmentioning

confidence: 99%

Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

Chitlangia

Shah

Poudel

et al. 2014

J. Nepal Paedtr. Soc.

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“…Calcium supplementation can be given during or after a blood exchange transfusion to increase the very low blood calcium values that develop during the E T (12). Seven of the infants received calcium infusions during blood exchange transfusion, and within 1 min after the first calcium injection the mean blood ionized calcium value was 2.11 mmol/l (range, 1.45-2.65 mmol/ 1).…”

Section: Blood Exchange Tram'iommentioning

confidence: 97%

Clinical and histologic appearance in enamel of primary teeth from children with neonatal hypocalcemia induced by blood exchange transfusion

Ranggård¹,

Östlund²,

Nelson³

et al. 1995

Acta Odontologica Scandinavica

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Clinical and histologic appearance in enamel of primary teeth from children with neonatal hypocalcemia induced by blood exchange transfusion, Acta Odontologica Scandinavica, 53:2, 123-128 To link to this article: http://dx.Ranggird L, Ostlund J, Nelson N, Nortn JG. Clinical and histologic appearance in enamel of primary teeth from children with neonatal hypocalcemia induced by blood exchange transfusion. Acta Odontol Scand 1995;30:122-128. Oslo. ISSN 0001-6357. ACTA ODONTOL SCANT) 53 (1995) -1 1 -ET days Hypocal. a 2 3 3 days X X X X X X X X Gat. age S 36 weeks

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“…In our study the high incidence of hypocalcaemia was because we did not use prophylactic calcium during the procedure unless it became symptomatic. Whilst 0.5-1.0 ml of 10% intravenous calcium gluconate, given after each 100 ml of exchange blood, may reduce incidence of hypocalcemia 18 , its use is controversial. Thrombocytopenia (36%) was another major adverse event.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and outcome of newborns who underwent double volume exchange transfusion in the neonatal intensive care unit at B.P. Koirala Institute of Health Sciences, Nepal

Kanodia

Yadav

Bhatta

et al. 2016

Sri Lanka J Child Health

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Introduction: About 50% term and 80% preterm babies develop neonatal jaundice. Treatment to prevent bilirubin encephalopathy consists of phototherapy or exchange transfusion (ET). ET is not risk free, and mortality rates vary from 0.5 to 3.3%.Objective: To report our observations on efficacy, adverse events and factors contributing to mortality related with ET performed for the treatment of neonatal hyperbilirubinemia at a tertiary-care centre.Method: This retrospective study was conducted at the neonatology division of B.P. Koirala Institute of Health Sciences, Nepal. All neonates who required ET for jaundice from January 2013 to December 2014 were included. Results: Sixty four neonates underwent double volumeET. Predominant causes of hyperbilirubinaemia were ABO incompatibility (32.8%), Rh incompatibility (17.2%) and idiopathic (20.3%). There was a mean reduction in serum bilirubin levels to 13.1±3.82 mg/dl in the post-ET and 14.63±3.16 mg/dl in the 6 hour post-ET period. The common adverse events were hypocalcaemia in 50% and thrombocytopenia in 35.9% of neonates. Other events such as hypoglycaemia (17.2%), apnoea (18.8%) and mortality (3.1%) occurred following ET.Conclusions: ABO incompatibility was the commonest cause for ET. Most of the complications were transient. Mortality rate was 3.1% in this study. _________________________________________

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Blood exchange transfusions in newborns, the effect on serum ionized calcium

Cited by 15 publications

References 13 publications

Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

Clinical and histologic appearance in enamel of primary teeth from children with neonatal hypocalcemia induced by blood exchange transfusion

Clinical profile and outcome of newborns who underwent double volume exchange transfusion in the neonatal intensive care unit at B.P. Koirala Institute of Health Sciences, Nepal

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