Document Detail

Exchange transfusion in infants with extreme hyperbilirubinemia: an experience from a developing country.
MedLine Citation:
PMID:  18422806     Owner:  NLM     Status:  MEDLINE    
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.
Ariel A Salas; Eduardo Mazzi
Related Documents :
12875876 - Antihemorrhagin in the blood serum of king cobra (ophiophagus hannah): purification and...
9417146 - Practice patterns in neonatal hyperbilirubinemia.
18116 - Bucolome in prevention of hyperbilirubinaemia in preterm infants.
18155166 - Glutathione-s-transferase (gst) m1 null genotype and combined gstm1 and gstt1 null geno...
17429916 - Determinants of breastfeeding initiation in xinjiang, pr china, 2003-2004.
19760396 - Detection of carbon dioxide thresholds using low-flow sidestream capnography in ventila...
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    
Department of Postgraduate Education and Research, Children's Hospital Dr. Ovidio Aliaga U, La Paz, Bolivia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Bilirubin / blood*
Bolivia / epidemiology
Epidemiologic Studies
Exchange Transfusion, Whole Blood*
Hyperbilirubinemia, Neonatal / complications,  epidemiology*,  physiopathology,  therapy*
Infant, Newborn
Kernicterus / epidemiology*,  etiology
Retrospective Studies
Risk Factors
Reg. No./Substance:

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

Previous Document:  Comparison of 2-h versus 3-h enteral feeding in extremely low birth weight infants, commencing after...
Next Document:  Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age.