[Biochemical and hematometric effects of exchange transfusion in isoimmunized neonates].
A hundred twenty full term newborns infants (RN) with ABO or Rh isoimmunization who were submitted to exchange transfusion (ET) because hyperbilirubinemia have been studied and with the procedure were demonstrated: 1. Increase the levels of serum sodium in 2.8% in the RN of ABO group and 3.2% in the RN of Rh group with a recurrence of the original values prior to the procedure within three hours post-ET. 2. The levels of serum sodium equal or superior to 180 mEq/L (mmol/L) in the donor's blood led to hypernatremia after the ET, with a recurrence of the original values prior to the procedures within three hours post-ET. 3. The levels of serum potassium of the RN decreased (-7.7% in the ABO group and -5.47% in the Rh group) with a recurrence of the normal values in the control of six hours post-ET in the ABO group and one of 12 hours in the Rh group. 4. The levels of total calcium in the controls haven't been significantly altered up to 24 hours post-ET. 5. Regarding the pH, in spite of having used blood with low levels compared to those expected for fresh blood, the RN for this experiment maintained the acid-base balance within normal range. In relation to the hematimetric values, the ET: 1. Increase both hemoglobin (Hb) and hematocrit (Hto) values in both groups (increase of 5.6% in Hb and 6% in Hto in the ABO group and increase of 9.2% in Hb and 6.1% in Hto in the Rh group), right after the ET, with a reduction in the control posterior to that. 2. The values of Hb and Hto were always inferior in the RN in the Rh group. Therefore, it has been shown the high intensity of the hemolysis in this group.
Jurfest-Ceccon
M E
ME
Departamento de Pediatría, Facultad de Medicina, Universidad de San Pablo, Brasil.
de Albuquerque Diniz
E M
EM
de Araujo-Ramos
J L
JL
Costa-Vaz
F A
FA
D000017:ABO Blood-Group System; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood / Q000009:adverse effects*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D006955:Hypernatremia / Q000209:etiology; D007008:Hypokalemia / Q000209:etiology; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000628:therapy*; D008297:Male; D012016:Reference Values; D012203:Rh Isoimmunization / Q000628:therapy*; D012204:Rh-Hr Blood-Group System
D000017:ABO Blood-Group System; D006454:Hemoglobins; D012204:Rh-Hr Blood-Group System