İndirekt Hiperbilirubinemide Exchange Transfüzyon Uygulanması: Tek Merkez Deneyimi

Abstract

Objective: Hyperbilirubinemia is a common clinical condition in newborn infants, and bilirubin encephalopathy remains an important health problem today. Decreased bilirubin anxiety and inadequate etiological evaluations lead to serious problems such as kernicterus. In this study, the development of bilirubin encephalopathy and its etiological causes were evaluated in patients who received exchange transfusion due to indirect hyperbilirubinemia for a period of one year. Methods: Newborns admitted to the Neonatology clinic between September 2020 and August 2021 due to indirect hyperbilirubinemia and undergoing exchange transfusion were analyzed retrospectively. Demographic data, laboratory parameters, and incidence of complications related to exchange transfusion were investigated. Results: A total of 62 infants, 61.3%(38) boys and 38.7%(24) girls, were included in the study. 53.2%(33) of the patients were delivered by cesarean section. Mean gestational age was 38(36-41) weeks and mean birth weight was 3063±478 grams. The median age at presentation was found to be 5 (1-22) days. In the etiological evaluation of the cases, 27.4%(44) Rh incompatibility, 50%(31) ABO incompatibility, 46.8%(29) Subgroup incompatibility were observed. More than one discrepancy was detected in 33.8%(21) of the patients. Glucose 6 phosphate dehydrogenase enzyme deficiency was detected in 21% (13) of the cases. No etiological cause was found in 4.8%(3) of the patients. Conclusion: Indirect hyperbilirubinemia and related bilirubin encephalopathy still remain a serious problem and therefore exchange transfusion may be required. In order to reduce serious morbidity and even mortality due to indirect hyperbilirubinemia, bilirubin monitoring should be done closely and risky babies should be determined in advance with etiological evaluations.