title: Blood exchange transfusion for infants with severe neonatal hyperbilirubinemia.
abstract: Blood exchange transfusion has become a rare event in most developed countries. As a result, many pediatricians may not have performed or even seen one. However, it remains a frequent emergency rescue procedure for severe neonatal hyperbilirubinemia in many underdeveloped regions of the world. Conventionally, exchange transfusion has been performed via a central umbilical venous catheter by pull-push cycle method and recently peripheral artery/peripheral vein has emerged as an alternative, isovolumetric route. Continuous arterio-venous exchange is possibly more effective though its automation has not been successful. Concerns for procedural and operator related adverse events have been raised in the context of declining indications. A required continued expertise for this life-saving intervention, in the face of rare but critical hyperbilirubinemia and/or unrecognized hemolytic diseases, deserves adaptation of newer technologies to make neonatal exchange transfusion a safer and more effective procedure. Technological innovations and simulation technologies are urgently needed.
authors.affiliation: Fernandez Hospital, Hyderabad, India.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Murki
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
mesh_terms: D005078:Exchange Transfusion, Whole Blood / Q000379:methods* / Q000592:standards; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000628:therapy*; D007231:Infant, Newborn