Complications of Exchange Transfusion in Hospitalized Neonates in Two Neonatal Centers in Hamadan, A Five-Year Experience

Abstract

Background: Exchange transfusion is commonly used in newborns for immediate treatment of severe hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus. Objectives: This study aimed to determine etiology and complications in newborns who received exchange transfusion for severe hyperbilirubinemia over the last five years. Patients and Methods: A retrospective study was performed on 28 days old infants who received exchange transfusion due to severe hyperbilirubinemia for a period of five years (from October 1st, 2006 through September 30th, 2011) in two neonatal units at Besat and Fatemieh hospitals in Hamadan, Iran. All data about patients' demographic characteristics, causes of hyperbilirubinemia, frequency, and complications of exchange transfusion were collected from medical records and analyzed using SPSS Version 12.0). Results: Exchange transfusion was performed in 148 neonates. Eighteen patients (12.2%) received exchange transfusion twice and seventeen patients (11.4%) three times or more. Among 118 neonates 80 (54.9%) were female and the mean gestational age and birth weight were 37.2 ± 2.5 weeks and 2847 ± 699 grams, respectively. The mean maximum total serum bilirubin levels were 27. 7.6 ± 7.28 mg/dL. Hemolytic disease was found in 72 (48.6%) of newborns. The most common cause of hemolysis was ABO incompatibility in 54 (36.5%). The etiologic factors were unidentified in 61 (41.2%) neonates. Complications occurred in 57 (38.5%) neonates and the most common complications were thrombocytopenia in 26 (17.6%) and hypocalcaemia in 17 (11.5%) neonates. Mortality was found in one (0.7%) neonate. Conclusions: The etiology of exchange transfusion was unidentified in most cases; however, ABO incompatibility was the most prevalent cause of hyperbilirubinemia. Complications were common after exchange transfusion and should be considered carefully.

Sex-wise changes in haematological and biochemical parameters before and after exchange transfusion in neonatal hyperbilirubinemia

“…Satyasree (2017) found in their study that there were 61.1% males and 38.8% females who had neonatal jaundice. 9 The present study is antithetical to the findings of Sabzehei et al (2015) 10 who found that among 148 neonates, 80 (54.9%) were female Rahman et al (2015) found 16 (41%) cases were male and 23 (59%). 11 Sex-wise changes in hematological and biochemical parameters before and after exchange transfusion in males and females:…”

Exchange Transfusion for Hyperbilirubinemia among Term and Near Term in NICU of a Tertiary Care Hospital of Bangladesh: Findings from a Prospective Study

“… 1 Kernicterus or bilirubin encephalopathy is caused by unconjugated hyperbilirubinemia that develops either as a result of hemolytic process or because of the inability of the liver to conjugate bilirubin. 2 The risk of mortality and severe long-term neurodevelopmental sequelae due to severe hyperbilirubinemia is high in low- and middle-income country like Bangladesh. The burden is likely to be exacerbated by lack of poor or timely access to proven therapies.…”

Exchange transfusion in initial phase of acute encephalopathy bilirubin of a 7-day old neonate: a case report

“…Complication occurred in 57 (38.5%) neonates and the most common complications were thrombocytopenia in 26 (17.6%) and hypocalcemia in 17 (11.5%) neonates. 22 In this case, patient had jaundice since the first day of life and become progressively increased accompanied by LAPSUS neurologic disorder. His laboratory result showed high level of total bilirubin and indirect bilirubin so we did exchange transfusion.…”