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Excessively high bilirubin and exchange transfusion in very low birth weight infants.
MedLine Citation:
PMID:  20846314     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim:  To evaluate the performance of exchange transfusion in very low birth weight (VLBW) infants with excessively high serum bilirubin levels. Methods:  A population-based observational study using data collected by the Israel National VLBW Infant Database. The study sample comprised 13 499 infants. Two definitions of excessively high-peak bilirubin levels that might be considered as threshold levels for performance of exchange transfusion were used. First, a bilirubin level of ≥15 mg/dL for all infants (PSB-15), and second, incremental bilirubin levels ranging from 12 to 17 mg/dL according to gestational age (PSB-GA). Results:  Four hundreds sixty-eight (3.5%) and 1035 infants (7.7%) infants in the PSB-15 and in the PSB-GA groups respectively had peak serum bilirubin levels above thresholds for exchange transfusion. Exchange transfusions were performed in 66 (14.1%) of these infants in the PSB-15 group and 91 (8.8%) in the PSB-GA group. Using logistic regression analysis, peak serum bilirubin was found as an independent factor for performing exchange transfusion. Conclusion:  Exchange transfusion was performed in only 9-14% of VLBW infants with excessively high bilirubin levels. We speculate that this may be a result of an absence of definitive guidelines or the possible belief that the risks of exchange transfusion outweigh the potential risk of bilirubin-induced neurological injuries.
Authors:
Jacob Kuint; Ayala Maayan-Metzger; Valentina Boyko; Liat Lerner-Geva; Brian Reichman;
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Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  100     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  506-10     Citation Subset:  IM    
Copyright Information:
© 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.
Affiliation:
Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Tel Aviv University, Israel Women and Children's Health Research Unit, Gertner Institute, Sheba Medical Center Ramat-Gan, and Sackler Faculty of Medicine, Tel Aviv University, Israel.
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