[Current validity of the exchange transfusion intervention by the classic indication. Our 15 years' experience]

Giovanni Vento, Patrizia Papacci, Antonio Alberto Zuppa, Assunta Tornesello, Carlo Fundaro', Costantino Romagnoli, M Micanti, C Coviello, A Palusci, Martina Mazzotta

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

In this paper the Authors report their personal experience of the use of exchange transfusion, secondary to classic indication, in the treatment of neonatal hyperbilirubinemia, in order to: 1) determine the trend over the past wears in the number of exchange transfused neonates, both from a global point of view and in relation to indications; 2) critically assess the risks, in terms of complications and mortality, correlated to exchange transfusion. Four hundred and eighty-eight neonates, who were subjected to 693 exchange transfusions in the Pediatric Clinic and Neonatal Division of the Policlinico Gemelli in Roma, were studied over a period of 15 years (1972-1986), according to the following indications: 214 cases of neonatal hyperbilirubinemia with MEN-Rh, 106 cases of neonatal hyperbilirubinemia with MEN-ABO and 168 cases of idiopathic hyperbilirubinemia. The total number of exchange transfused neonates decreased drastically from 304 in the period 1972-76 to 65 in the period 1982-86. The frequency of exchange transfused neonates because of idiopathic hyperbilirubinemia decreased significantly (p greater than 0.001), booth in comparison to the number of live births and in comparison to the number of exchange transfused neonates, probably due to the gradual introduction of phototherapy. The frequency of exchange transfused neonates with iso-Rh and iso-ABO decreased or remained stationary on account of the confirmed relative lesser efficacy of phototherapy on hemolytic jaundice. With regard to mortality and morbidity, 27 out of 488 neonates died during the neonatal period, but only 4 within six hours of exchange transfusion; the majority of those who died had a reduced gestational age and low birthweight, and were affected by a severe associated pathology.
Titolo tradotto del contributo[Autom. eng. transl.] [Current validity of the exchange transfusion intervention by the classic indication. Our 15 years' experience]
Lingua originaleItalian
pagine (da-a)135-141
Numero di pagine7
RivistaMinerva Pediatrica
Volume42
Stato di pubblicazionePubblicato - 1990

Keywords

  • ABO Blood-Group System
  • Blood Group Incompatibility
  • Evaluation Studies as Topic
  • Exchange Transfusion, Whole Blood
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases
  • Jaundice, Neonatal
  • Rh Isoimmunization

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