Exchange transfusion for neonatal hyperbilirubinemia: A multicenter, prospective study of Turkish Neonatal Society
- PMID: 34286320
- PMCID: PMC8269941
- DOI: 10.14744/TurkPediatriArs.2020.65983
Exchange transfusion for neonatal hyperbilirubinemia: A multicenter, prospective study of Turkish Neonatal Society
Erratum in
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Erratum.Turk Arch Pediatr. 2021 Nov;56(6):657. doi: 10.5152/TurkArchPediatr.2021.21121021. Turk Arch Pediatr. 2021. PMID: 35110070 Free PMC article. No abstract available.
Abstract
Objective: The frequency of neonatal exchange transfusion has declined in recent years, but is still performed in many countries. The procedure is associated with complications. The aim of the study was to determine the clinical features and etiologies of infants with hyperbilirubinemia who underwent exchange transfusion and evaluate the adverse events and clinical outcomes.
Material and methods: We performed a secondary analysis of the multicenter Turkish Neonatal Jaundice Online Registry data. Otherwise healthy newborns born ≥35 weeks of gestation who were hospitalized for jaundice and underwent exchange transfusion were included.
Results: One-hundred thirty-two patients with a mean serum bilirubin level on admission of 24.9±9.1 mg/dL were enrolled in the study. The most common cause for exchange transfusion was hemolytic jaundice (63.6%), followed by lack of proper feeding (12.9%). It was found that the infants with lack of proper feeding were discharged earlier from the maternity ward (p=0.02), but they were admitted to hospital later (p<0.001) with a higher bilirubin level (p=0.001), and geater weight loss (p=0.04). The reported rate of adverse events associated with exchange transfusion was 11.4%. The most common complication was thrombocytopenia (40%). None of the infants died during the procedure. Acute bilirubin encephalopathy was reported in 13 (9.8%) patients.
Conclusion: Severe hyperbilirubinemia requiring exchange transfusion and acute bilirubin encephalopathy are still challenging problems in neonatal periodin our country. The policies including blood group analysis of pregnant women, programs informing parents about breastfeeding and jaundice, and monitoring bilirubin levels of high-risk newborns should be developed to reduce the necessitating for exchange transfusion and to avoid related complications.
Keywords: Complication; exchange transfusion; hyperbilirubinemia; newborn.
Copyright © 2021 Turkish Pediatric Association.
Conflict of interest statement
Conflict of Interest: The authors of have no conflicts of interest, including specific financial interests, relationships and/or affiliations relevant to the subject matter or materials included.
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References
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- Practice parameter: management of hyperbilirubinemia in the healthy term newborn. American Academy of Pediatrics and Provisional Committee for Quality Improvement and Subcommittee on Hyperbilirubinemia. Pediatrics. 1994;94:558–65. - PubMed
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