Document Detail


Exchange transfusion in infants with extreme hyperbilirubinemia: an experience from a developing country.
MedLine Citation:
PMID:  18422806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the clinical and epidemiological features of infants with extreme hyperbilirubinemia who require exchange transfusion (ET). STUDY DESIGN: Term and near-term infants admitted to a paediatric hospital over a 5-year period in La Paz, Bolivia, were included in the study if they met the following criteria: age less than 30 days; total serum bilirubin (TSB) levels > or =428 micromol/L (> or =25 mg/dL) on admission and if they had undergone an ET. RESULTS: Fifty-six infants were identified during the study period. Most of them were exclusively breastfed (98.2%). Median age at admission was 7 days. Weight loss of more than 12% since birth, as well as dehydration, was registered in more than one-third of cases. Extreme hyperbilirubinemia was considered as secondary to increased enterohepatic circulation (EHC) in most cases (73%). The mean TSB level on admission was 531.8 micromol/L (31.1 mg/dL). Fifteen infants (26.8%) showed signs of acute bilirubin encephalopathy (ABE). Early ABE was reversible after ET in most cases but all infants with advanced ABE developed severe kernicteric sequelae. Nine patients (16.1%) developed adverse events attributable to ET. CONCLUSIONS: Dehydration and weight loss in breastfed infants appeared to be an important factor associated with extreme hyperbilirubinemia and secondary brain damage during the first week of life. This may well be avoided if signs of ABE and its associated conditions are identified appropriately by follow-up programmes.
Authors:
Ariel A Salas; Eduardo Mazzi
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Publication Detail:
Type:  Journal Article     Date:  2008-04-16
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  97     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-07     Completed Date:  2008-10-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  754-8     Citation Subset:  IM    
Affiliation:
Department of Postgraduate Education and Research, Children's Hospital Dr. Ovidio Aliaga U, La Paz, Bolivia. dr.ariel.salas@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Bilirubin / blood*
Bolivia / epidemiology
Epidemiologic Studies
Exchange Transfusion, Whole Blood*
Female
Humans
Hyperbilirubinemia, Neonatal / complications,  epidemiology*,  physiopathology,  therapy*
Infant
Infant, Newborn
Kernicterus / epidemiology*,  etiology
Male
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
635-65-4/Bilirubin

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


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