Clinical analysis of exchange transfusion for treatment of severe neonatal hyperbilirubinemia in newborns on me-chanical ventilation
10.3969/j.issn.1000-3606.2013.12.012
- VernacularTitle:机械通气下换血疗法治疗极危重新生儿高胆红素血症的临床分析
- Author:
Qiaozhen WEI
;
Ping SU
;
Xia ZHANG
;
Yuhui DUAN
- Publication Type:Journal Article
- Keywords:
exchange transfusion;
mechanical ventilation;
hyperbilirubinemia;
critical illness;
newborn
- From:
Journal of Clinical Pediatrics
2013;(12):1147-1150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the conditions, safety and efifcacy of exchange transfusion for extremely severe hyper-bilirubinemia in term newborns requiring mechanical ventilation. Methods Ten full-term newborns of extremely severe hyper-bilirubinemia requiring mechanical ventilation were selected from January 2010 to March 2013 in the department of neonatology. After stable vital sign was achieved by the use of conventional life support, peripheral arterial and venous synchronous exchange transfusion was performed. The bilirubin, platelets, blood calcium, blood coagulation and blood gas were monitored before and after exchange transfusion. The effects and adverse events of exchange transfusion in newborns on mechanical ventilation were observed. Results There was no death in the study, and the replacement rate of total bilirubin was 50.5%. The main adverse event was thrombocytopenia (80%). There was a signiifcant difference in platelet counting before and after exchange transfusion (P<0.05). There was no signiifcant difference in blood coagulation, pH/HCO3-of the blood gas, prothrombin time (PT) and acti-vated partial thromboplastin time (APTT) before and after exchange transfusion. Conclusions It is relatively safe to implement an exchange transfusion in the full-term newborns with severe hyperbilirubinemia in newborns requiring mechanical ventilation, but the use of conventional life support is prerequisite because it stabilizes vital signs. The relatively ideal replacement rate of bili-rubin and the low incidence of adverse reactions are expected. However long-term prognosis of neural system is still unknown.
