Intravenous immunoglobulin in the management of hemolytic disease of the newborn.
Jaundice caused by hemolysis continues to challenge practitioners caring for infants in the NICU. Bilirubin levels can rise quickly in the first days of life, and interventions must be prompt to prevent side effects related to hyperbilirubinemia. Conventional treatments such as hydration and phototherapy are common, but new studies suggest that use of intravenous immunoglobin (IVIG) as an additional treatment may prevent the need for exchange transfusion in some babies. This article presents a case study of an infant with blood-type incompatibility treated successfully with multiple doses of IVIG, discusses the pathophysiology and clinical presentation of hemolytic jaundice, and reviews current management strategies for this disease.
Mundy
Cynthia A
CA
School of Nursing, Medical College of Georgia, Augusta 30912, USA. cmundy@mcg.edu
D000017:ABO Blood-Group System; D000328:Adult; D001663:Bilirubin / Q000097:blood; D001787:Blood Group Incompatibility / Q000150:complications; D002985:Clinical Protocols; D016903:Drug Monitoring; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000209:etiology / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D006400:Hematocrit; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007567:Jaundice, Neonatal / Q000209:etiology; D008665:Metalloporphyrins / Q000627:therapeutic use; D017283:Neonatal Nursing; D024802:Nurse's Role; D010789:Phototherapy; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000150:complications
D000017:ABO Blood-Group System; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D008665:Metalloporphyrins; D001663:Bilirubin