Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience
Background and Objectives: Double-volume exchange transfusion (DVET) is a life-saving procedure that replaces a neonate’s blood volume twice over with adult donor blood to treat neonatal hyperbilirubinemia and prevent kernicterus. This study assessed DVET’s effectiveness in reducing total serum bili...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Global Journal of Transfusion Medicine |
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| Online Access: | https://journals.lww.com/10.4103/gjtm.gjtm_78_23 |
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| _version_ | 1846139423641567232 |
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| author | Kaushik Patra Smita Mahapatra |
| author_facet | Kaushik Patra Smita Mahapatra |
| author_sort | Kaushik Patra |
| collection | DOAJ |
| description | Background and Objectives:
Double-volume exchange transfusion (DVET) is a life-saving procedure that replaces a neonate’s blood volume twice over with adult donor blood to treat neonatal hyperbilirubinemia and prevent kernicterus. This study assessed DVET’s effectiveness in reducing total serum bilirubin (TSB) concentration in neonates at risk of kernicterus and examined the disease conditions that necessitate DVET.
Methods:
This observational study assessed the effectiveness of DVET in 104 neonates at risk of kernicterus. Neonates meeting the American Academy of Pediatrics guidelines were selected. Blood samples were collected before and 24 h after DVET for TSB estimation and complete blood count analysis. Blood components were selected based on ABO, Rh, and other minor blood group incompatibility. DVET was performed using the push–pull method.
Results:
This study of DVET in 104 neonates with hyperbilirubinemia found that DVET is an effective treatment, reducing TSB levels by 61.72% on average. The most common cause of hyperbilirubinemia was idiopathic (25.6%), followed by ABO incompatibility (22.12%) and anti-D alloimmunization (17.31%). In hypothyroid, preterm, and sepsis cases, hemoglobin levels decreased by an average of 17.7%, 12.9%, and 13.9%, respectively, after DVET. However, in cases of minor alloimmunization and anti-D alloimmunization, hemoglobin levels increased by an average of 29% and 40.5%, respectively, after DVET. The maximum decrease in TSB level was observed in cases of ABO incompatibility with sepsis (82%), while the minimum decrease was seen in neonates undergoing DVET due to sepsis (50%). The percentage reduction of TSB level after DVET was similar for different etiologies, ranging from 50.2% to 65.4%.
Conclusion:
DVET is a rarely used procedure in the age of phototherapy and intravenous immunoglobulin for neonatal hyperbilirubinemia. However, it is the only effective treatment for very high bilirubin levels to prevent kernicterus or bilirubin encephalopathy. |
| format | Article |
| id | doaj-art-9a58be81cde240909ae584c8f81e8b43 |
| institution | Kabale University |
| issn | 2468-8398 2455-8893 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Global Journal of Transfusion Medicine |
| spelling | doaj-art-9a58be81cde240909ae584c8f81e8b432024-12-06T10:12:28ZengWolters Kluwer Medknow PublicationsGlobal Journal of Transfusion Medicine2468-83982455-88932024-11-019213013310.4103/gjtm.gjtm_78_23Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center ExperienceKaushik PatraSmita MahapatraBackground and Objectives: Double-volume exchange transfusion (DVET) is a life-saving procedure that replaces a neonate’s blood volume twice over with adult donor blood to treat neonatal hyperbilirubinemia and prevent kernicterus. This study assessed DVET’s effectiveness in reducing total serum bilirubin (TSB) concentration in neonates at risk of kernicterus and examined the disease conditions that necessitate DVET. Methods: This observational study assessed the effectiveness of DVET in 104 neonates at risk of kernicterus. Neonates meeting the American Academy of Pediatrics guidelines were selected. Blood samples were collected before and 24 h after DVET for TSB estimation and complete blood count analysis. Blood components were selected based on ABO, Rh, and other minor blood group incompatibility. DVET was performed using the push–pull method. Results: This study of DVET in 104 neonates with hyperbilirubinemia found that DVET is an effective treatment, reducing TSB levels by 61.72% on average. The most common cause of hyperbilirubinemia was idiopathic (25.6%), followed by ABO incompatibility (22.12%) and anti-D alloimmunization (17.31%). In hypothyroid, preterm, and sepsis cases, hemoglobin levels decreased by an average of 17.7%, 12.9%, and 13.9%, respectively, after DVET. However, in cases of minor alloimmunization and anti-D alloimmunization, hemoglobin levels increased by an average of 29% and 40.5%, respectively, after DVET. The maximum decrease in TSB level was observed in cases of ABO incompatibility with sepsis (82%), while the minimum decrease was seen in neonates undergoing DVET due to sepsis (50%). The percentage reduction of TSB level after DVET was similar for different etiologies, ranging from 50.2% to 65.4%. Conclusion: DVET is a rarely used procedure in the age of phototherapy and intravenous immunoglobulin for neonatal hyperbilirubinemia. However, it is the only effective treatment for very high bilirubin levels to prevent kernicterus or bilirubin encephalopathy.https://journals.lww.com/10.4103/gjtm.gjtm_78_2324 hdouble-volume exchange transfusionexchange transfusionhyperbilirubinemiajaundiceneonate |
| spellingShingle | Kaushik Patra Smita Mahapatra Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience Global Journal of Transfusion Medicine 24 h double-volume exchange transfusion exchange transfusion hyperbilirubinemia jaundice neonate |
| title | Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience |
| title_full | Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience |
| title_fullStr | Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience |
| title_full_unstemmed | Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience |
| title_short | Effectiveness of Double-volume Exchange Transfusion in Neonates with Hyperbilirubinemia: A Single-center Experience |
| title_sort | effectiveness of double volume exchange transfusion in neonates with hyperbilirubinemia a single center experience |
| topic | 24 h double-volume exchange transfusion exchange transfusion hyperbilirubinemia jaundice neonate |
| url | https://journals.lww.com/10.4103/gjtm.gjtm_78_23 |
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