title: Two-stage single-volume exchange transfusion in severe hemolytic disease of the newborn.
abstract: OBJECTIVE
  Evaluation of two-stage single-volume exchange transfusion (TSSV-ET) in decreasing the post-exchange rebound increase in serum bilirubin level, with subsequent reduction of the need for repeated exchange transfusions.
  
  
  METHODS
  The study included 104 neonates with hyperbilirubinemia needing exchange transfusion. They were randomly enrolled into two equal groups, each group comprised 52 neonates. TSSV-ET was performed for the 52 neonates and the traditional single-stage double-volume exchange transfusion (SSDV-ET) was performed to 52 neonates.
  
  
  RESULTS
  TSSV-ET significantly lowered rebound serum bilirubin level (12.7 ± 1.1 mg/dL), compared to SSDV-ET (17.3 ± 1.7 mg/dL), p < 0.001. Need for repeated exchange transfusions was significantly lower in TSSV-ET group (13.5%), compared to 32.7% in SSDV-ET group, p < 0.05. No significant difference was found between the two groups as regards the morbidity (11.5% and 9.6%, respectively) and the mortality (1.9% for both groups).
  
  
  CONCLUSIONS
  Two-stage single-volume exchange transfusion proved to be more effective in reducing rebound serum bilirubin level post-exchange and in decreasing the need for repeated exchange transfusions.
authors.affiliation: Neonatal ICU, Maternity Hospital, Ain Shams University, Cairo, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: Abbas
authors.forename: Nayera I
authors.initials: NI
authors.lastname: Attia
authors.forename: Sahar M A
authors.initials: SM
authors.lastname: Hassanein
mesh_terms: D001663:Bilirubin / Q000097:blood; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin