Volume 7, Issue 1 (3-2021)
CJP 2021, 7(1): 0 |
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Kaveh M, Adutwum E, Kaji Yazdi M. Short-term complications associated with exchange transfusion in neonates with severe hyperbilirubinemia. CJP 2021; 7 (1) :479-487
URL: http://caspianjp.ir/article-1-139-en.html
URL: http://caspianjp.ir/article-1-139-en.html
Assistant Professor of Pediatric Hematology and Oncology, Tehran University of Medical Sciences, Tehran, Iran , mkajiyazdi50@gmail.com
Abstract: (3122 Views)
Background and Objective: Neonatal jaundice is a common condition among neonates in the first few days of life and is a leading cause of admission among neonates. The aim of this study was to investigate the most common risk factors associated with severe neonatal hyperbilirubinemia (NNH) and short-term complications of the exchange transfusion (ET).
Methods: In this retrospective study, the medical records of newborns <28 days with severe hyperbilirubinemia who underwent ET during 2015-2018 were analyzed. Medical records and files were searched using the keyword “exchange transfusion”. The clinical and demographic characteristics of the study population as well as the short-term complications of ET were descriptively analyzed.
Findings: Totally, 74 newborns with the mean age of 5.6 ± 3.4 days were included in the current study. The baseline mean peak total serum bilirubin (TSB) was 25.8 ± 5.7 mg/dl. In neonates, the ABO incompatibility was the most frequent cause of severe hyperbilirubinemia requiring ET (54.1%), followed by sepsis (39.2%). Moreover, 57.7% of neonates developed complications secondary to ET. The most common complication was hyperglycemia (71.6%), followed by thrombocytopenia (48.6%).
Conclusion: Hemolysis and sepsis are common causes of NNH; therefore, the extensive screening and identification of the at-risk population can help decrease the incidence of severe NNH. Frequent monitoring of blood sugar and screening of thrombocytopenia before and after ET procedures are necessary to reduce adverse events.
Methods: In this retrospective study, the medical records of newborns <28 days with severe hyperbilirubinemia who underwent ET during 2015-2018 were analyzed. Medical records and files were searched using the keyword “exchange transfusion”. The clinical and demographic characteristics of the study population as well as the short-term complications of ET were descriptively analyzed.
Findings: Totally, 74 newborns with the mean age of 5.6 ± 3.4 days were included in the current study. The baseline mean peak total serum bilirubin (TSB) was 25.8 ± 5.7 mg/dl. In neonates, the ABO incompatibility was the most frequent cause of severe hyperbilirubinemia requiring ET (54.1%), followed by sepsis (39.2%). Moreover, 57.7% of neonates developed complications secondary to ET. The most common complication was hyperglycemia (71.6%), followed by thrombocytopenia (48.6%).
Conclusion: Hemolysis and sepsis are common causes of NNH; therefore, the extensive screening and identification of the at-risk population can help decrease the incidence of severe NNH. Frequent monitoring of blood sugar and screening of thrombocytopenia before and after ET procedures are necessary to reduce adverse events.
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- Hemolysis and sepsis are common causes of neonatal hyperbilirubinemia (NNH).
- The extensive screening and identification of the at-risk population can help decrease the incidence of severe NNH.
- Most of the short-term complications of ET are reversible as well as metabolic and laboratory abnormalities.
- Frequent monitoring of blood sugar and management of electrolyte abnormalities as well as screening for thrombocytopenia before and after ET procedures are necessary to reduce adverse events.
- It seems that the use of RBCs for newborns <5 days old, may lead to reduce the incidence of post-ET complications and the need for another ET during hospitalization.
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