Document Detail

Adverse events associated with exchange transfusion in healthy and ill newborns.
MedLine Citation:
PMID:  9113964     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the incidence of adverse events attributable to exchange transfusion during the past 15 years and compare the incidence of severe complications between healthy and ill infants. DESIGN: Medical records for the past 15 years from two teaching hospitals with neonatal intensive care units were reviewed. Those newborns who underwent exchange transfusions were classified as healthy or ill. Adverse events were analyzed to determine whether they were attributable to the procedure. RESULTS: Of the 106 patients who underwent exchange transfusion, 81 were healthy and had no medical problems other than jaundice. The remaining 25 patients were classified as ill and had medical problems ranging from mild to severe. At least 2 (2%) of the 106 patients died of complications probably attributable to exchange transfusion. None of the 81 healthy infants died, but 1 had severe necrotizing enterocolitis requiring surgery. Of the 25 ill infants, at least 3 (12%) experienced severe complications (including 2 deaths) probably attributable to exchange transfusion. Serious complications from the most common adverse events, hypocalcemia and thrombocytopenia, were limited to the group of infants already ill with other medical problems. CONCLUSIONS: Because of the significantly greater rate of severe complications in ill infants, exchange transfusion should be delayed until the risk of bilirubin encephalopathy is as high as the risks of severe complications from the procedure itself (12%). These results do not support recommendations to use lower exchange levels in ill infants compared with healthy infants.
J C Jackson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  99     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1997 May 
Date Detail:
Created Date:  1998-09-14     Completed Date:  1998-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  E7     Citation Subset:  IM    
Department of Pediatrics, University of Washington, Children's Hospital and Medical Center, Seattle, WA 98105-0371, USA.
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MeSH Terms
Bacteremia / etiology
Body Weight
Cause of Death*
Confidence Intervals
Exchange Transfusion, Whole Blood / adverse effects*,  mortality
Gestational Age
Hyaline Membrane Disease / therapy
Hypertension, Renovascular / etiology
Infant, Newborn
Intensive Care Units, Neonatal / statistics & numerical data
Jaundice, Neonatal / etiology
Medical Records / statistics & numerical data
Prospective Studies
Respiratory Tract Diseases / etiology
Severity of Illness Index
Staphylococcal Infections / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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