Abstract
Background: There are limited data on the outcome of babies following exchange transfusions(ExT).
Aims: To review and define the postnatal outcomes in babies who received ExT.
Methods: All babies receiving ExT between 01/01/96 to 31/12/06 were identified using neonatal database. Data were extracted from the case notes.
Results: 140 ExTs were performed in 108 neonates. 106 (98%) babies survived to discharge. Indications for ExT included jaundice in 83/140 (59%), anaemia in 56/140 (40%), and DIC in 1/140. 131/140 (94%) were double and 9/140 (6%) were single volume ExTs. 78% of ExTs were performed using UAC remaining using UVC or peripheral arteries. In 124/140 (89%) there were no procedural complications. There were mild complications in 11/140 (8%) requiring either no or minimal intervention. ExT was abandoned in 5/140 (4%) due to difficulty in sampling or aspiration of blood. Two babies died i) DIC ii) hydrops. One baby developed NEC. Although there were significant falls in the post ExT platelet count and calcium, only 3 required platelet transfusion and none required calcium correction. Of the 106 babies surviving to discharge, 94 were followed up to at least one year. One died at 5 months (SIDS) and 11 were transferred elsewhere. 91/94 (97%) had normal hearing, vision and development. 3 babies had sensori-neural deafness and speech delay, one baby born at 33 weeks developed spastic quadriplegia and global developmental delay.
Conclusion: ExT has good safety profile and effective treatment outcome. In our experience, there were no significant sequelae attributable to the procedure.
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Chandra, P., Ewer, A. & Rasiah, S. 1144 Outcomes of Neonatal Exchange Transfusion - 11 Year Experience at a Tertiary Centre in the Uk. Pediatr Res 68 (Suppl 1), 567 (2010). https://doi.org/10.1203/00006450-201011001-01144
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DOI: https://doi.org/10.1203/00006450-201011001-01144
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