Exchange transfusions via peripheral vessels.
During a 15 month period, partial exchange transfusions (ET) were done in 40 neonates with polycythemia, and double volume ET attempted in 7 neonates with hyperbilirubinemia via peripheral vessels. The procedure was effective and not associated with any complications for partial ET. During double volume ET minor complications were noted in 2 cases, both of whom recovered and subsequently successfully underwent supraumbilical ET. Of the 5 cases who had uneventful double volume exchanges, there was a significant drop in indirect serum bilirubin following the procedure. The mean pre-ET serum indirect bilirubin in these 5 cases was 334 mumol/L and mean post-ET level was 179 mumol/L with a mean drop of 155 mumol/L (46% drop). Technical difficulties in catheterization may be overcome with greater expertise and use of heparin to flush arterial catheters.
Merchant
R H
RH
B.J. Wadia Hospital for Children, Bombay.
Sakhalkar
V S
VS
Rajadhyaksha
S B
SB
D001158:Arteries; D001663:Bilirubin / Q000097:blood; D002406:Catheterization, Peripheral / Q000379:methods; D005078:Exchange Transfusion, Whole Blood / Q000379:methods*; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000628:therapy*; D007231:Infant, Newborn; D011086:Polycythemia / Q000097:blood / Q000628:therapy*; D011884:Radius / Q000098:blood supply; D016909:Tibial Arteries; D014471:Umbilical Veins
D001663:Bilirubin