What is double volume exchange?
Double volume exchange transfusion most commonly used for removal of bilirubin and antibodies. 2 x circulating blood volume (for example, for a term infant 2 x 80ml/kg = 160ml/kg) Replaces approximately 85% of the blood volume.
What is a double volume exchange transfusion?
The affected infant’s blood is removed in small portions and equal volume of blood is replaced during exchange transfusion. Traditionally twice the blood volume of baby is removed and the replaced with fresh blood.
What is exchange transfusion hyperbilirubinemia?
Exchange transfusion (ET) provides rapid reduction of circulating bilirubin, so it could represent appropriate treatment in many cases of severe hyperbilirubinemia in the neonatal period [1–3]. Treatment involves removal of the infant’s blood and simultaneous replacement with compatible donor blood [4, 5].
What level of bilirubin requires exchange transfusion?
Cord bilirubin levels >5 mg/dl, bilirubin levels that rise >1 mg/dl/hour, or indirect bilirubin levels >20 mg/dl are all potential indications for exchange transfusion.
What is kernicterus disease?
Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby’s blood. It can cause athetoid cerebral palsy and hearing loss. Kernicterus also causes problems with vision and teeth and sometimes can cause intellectual disabilities.
How do you calculate double exchange transfusion?
Double Volume Exchange The exchange volume is twice the infant’s blood volume, using 85 ml/kg as the infant’s blood volume. This procedure should be done slowly, over a minimum of 45 minutes and the blood volume should be kept fairly constant.
What is the treatment for hyperbilirubinemia?
Treatment may include: Phototherapy. Since bilirubin absorbs light, jaundice and increased bilirubin levels usually decrease when the baby is exposed to special blue spectrum lights. Phototherapy may take several hours to begin working and it is used throughout the day and night.
Who is at risk for hyperbilirubinemia?
Common risk factors for hyperbilirubinemia include fetal-maternal blood group incompatibility, prematurity, and a previously affected sibling (Table 1). 2–4 Cephalohematomas, bruising, and trauma from instrumented delivery may increase the risk for serum bilirubin elevation.
What is acute bilirubin encephalopathy?
Acute bilirubin encephalopathy encompasses the acute illness caused by severe hyperbilirubinemia. Presenting signs and symptoms include decreased feeding, lethargy, abnormal tone (hypotonia and/or hypertonia), high-pitched cry, retrocollis and opisthotonus, setting-sun sign, fever, seizures, and possibly death [6,7].
What are the signs of bilirubin toxicity that leads to kernicterus?
Toxic levels of bilirubin may accumulate in the brain, potentially resulting in a variety of symptoms and physical findings. These symptoms may include lack of energy (lethargy), poor feeding habits, fever, and vomiting.
How do you confirm kernicterus?
Kernicterus is most often diagnosed in babies. One test that may be used to check bilirubin levels is a light meter. A doctor or nurse will check your baby’s bilirubin levels by placing the light meter on your baby’s head.
When to use double volume transfusion for jaundice?
Double volume exchange transfusion is commonly used in newborns with severe jaundice in order to prevent kernicterus and other toxicity related to hyperbilirubinemia.
Where can I find research on hyperbilirubinemia?
The main databases including Scopus, Pubmed, MEDLINE, Google scholar and Science Direct were researched to obtain the original papers related to the newborns’ hyperbilirubinemia. The main terms used to literature search were “newborns’ hyperbilirubinemia”, “newborns’ jaundice”, “Physiological Jaundice” and “Patholigical Jaundice”.
Where does hyperbilirubinemia usually occur in a newborn?
In neonates, the dermal icterus is first noted in the face and when the bilirubin level rises, it proceeds to the body and then to the extremities. This condition is common in 50%–60% of newborns in the first week of life (8).
When to use double volume exchange transfusions?
Read the full abstract… Background: Double volume exchange transfusion is commonly used in newborns with severe jaundice in order to prevent kernicterus and other toxicity related to hyperbilirubinemia. Most commonly, exchange transfusions are used in infants with rhesus hemolytic disease.