Anemia ; therapy ; Erythrocyte Transfusion ; Exchange Transfusion, Whole Blood ; Female ; Hematocrit ; Hemoglobins ; analysis ; Humans ; Infant, Newborn ; Male

Clinical Competence ; Clozapine ; poisoning ; Exchange Transfusion, Whole Blood ; First Aid ; Humans ; Infant, Newborn

OBJECTIVETo study the effect of automated peripheral arteriovenous exchange transfusion for treatment of severe hyperbilirubinemia in neonates.

METHODSFifty-three neonates with severe hyperbilirubinemia underwent automated peripheral arteriovenous exchange transfusion, and the changes in the blood gas, electrolytes and some biochemical indices after the exchange transfusion were evaluated.

RESULTSTreatment with the exchange transfusion resulted in a significant reduction in the total serum bilirubin with an exchange rate of 53.12% (P<0.01). The levels of serum kalium, calcium, magnesium, white blood cell count, platelets, and pH showed reductions while blood glucose exhibited a significant elevation changes after the transfusion (P<0.01), which all recovered the normal levels within 48 h. No obvious alterations occurred in the respiration, heart rate, blood pressure, or saturation of blood oxygen during the transfusion.

CONCLUSIONAutomated peripheral arteriovenous exchange transfusion can rapidly reduce serum bilirubin levels in neonates with severe hyperbilirubinemia without obviously affecting the blood gas balance or blood electrolyte or glucose levels.

OBJECTIVE: To study the effect of red blood cell (RBC) storage duration on the clinical effect of exchange transfusion (ET) and internal environment in neonates with hyperbilirubinemia. METHODS: A retrospective analysis was performed for the clinical data of 135 neonates with hyperbilirubinemia who received ET between January 2015 and August 2018. According to RBC storage duration, the neonates were divided into short-term storage group (RBCs were stored for ≤7 days) with 56 neonates and long-term storage group (RBCs were stored for >7 days) with 79 neonates. The two groups were compared in terms of serum total bilirubin (TBIL) level and the rate of TBIL reduction at 0 and 12 hours after ET, as well as the duration of continued phototherapy and rate of repeated ET. Routine blood test parameters, electrolytes, blood glucose, and blood gas parameters were measured before ET and at 0 hour after ET. RESULTS: At 0 hour after ET, there were no significant differences in the TBIL level and the rate of TBIL reduction between the two groups (P>0.05). At 12 hours after ET, the long-term storage group had a significantly higher TBIL level and a significantly lower rate of TBIL reduction than the short-term storage group (P<0.01). The long-term storage group had a significantly longer duration of continued phototherapy after ET than the short-term storage group (P<0.05). Compared with the short-term storage group, the long-term storage group had significantly higher incidence rates of ET-related complications, including hyponatremia, hyperkalemia, and metabolic acidosis (P<0.05). CONCLUSIONS The use of RBCs with a storage duration of >7 days in ET for neonates with hyperbilirubinemia does not affect the immediate effect of ET, but these neonates tend to have a poor outcome after continued phototherapy and high risk of hyponatremia, hyperkalemia, and metabolic acidosis.
Bilirubin ; Erythrocytes ; Exchange Transfusion, Whole Blood ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Neonatal ; Infant, Newborn ; Phototherapy ; Retrospective Studies

At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.
Anti-Bacterial Agents ; Child ; Exchange Transfusion, Whole Blood ; Humans ; Whooping Cough/drug therapy*

Blood Cell Count ; Exchange Transfusion, Whole Blood ; adverse effects ; methods ; Female ; Humans ; Hyperbilirubinemia, Neonatal ; blood ; therapy ; Infant, Newborn ; Male

Antipsychotic Agents ; poisoning ; Clozapine ; blood ; poisoning ; Exchange Transfusion, Whole Blood ; methods ; Humans ; Infant, Newborn ; Male ; Treatment Outcome

Exchange Transfusion, Whole Blood ; methods ; Female ; Follow-Up Studies ; Humans ; Hyperbilirubinemia, Neonatal ; blood ; therapy ; Infant, Newborn ; Male

International guidelines regarding the role of intravenous immunoglobulin (IVIG) in the management of Rh- and ABO-mediated haemolytic disease of the newborn was drafted by an international panel of experts in the fields of hematology, neonatology, and blood transfusion and was published in British Journal of Haematology on March 16, 2022. The guidelines summarize the evidence-based practice of IVIG in Rh- and ABO-mediated haemolytic disease of the newborn and propose related recommendations. The guidelines recommend that IVIG should not be applied as a routine treatment regimen for Rh- and ABO-mediated haemolytic disease of the newborn in order to reduce exchange transfusion (ET), and the best time to apply IVIG remains unclear in the situations where hyperbilirubinaemia is severe (approaching or exceeding the ET threshold) or ET cannot be implemented. These guidelines are formulated with rigorous methods, but with the lower quality of evidence.
Infant, Newborn ; Female ; Humans ; Immunoglobulins, Intravenous/therapeutic use* ; Erythroblastosis, Fetal/drug therapy* ; Exchange Transfusion, Whole Blood ; Hematologic Diseases ; Hyperbilirubinemia

Short-term outcome in very low birthweight babies has never been closely examined in Papua New Guinea. A cohort of neonates born over a year at Port Moresby General Hospital was followed from birth to death or discharge. Intrauterine growth retardation was an important contributor to low birthweight. Simple, inexpensive care resulted in respectable survival figures. Improving antenatal surveillance will have much more impact in reducing mortality in this group in the future than trying to emulate sophisticated and costly western neonatal care.
Antibiotic Prophylaxis ; Birth Weight ; Cohort Studies ; Exchange Transfusion, Whole Blood ; Female ; Fetal Growth Retardation - complications ; Respiratory Distress Syndrome, Newborn - therapy