Clinical characteristics and causes of exchange transfusion in term neonates with hyperbilirubinemia Hiperbilirubinemi nedeniyle kan deǧişimi uygulanan zamaninda doǧmuş bebeklerin klinik özellikleri ve kan deǧişimi nedenleri
Turk Pediatri Arsivi, cilt.42, sa.3, ss.107-111, 2007 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 42 Sayı: 3
- Basım Tarihi: 2007
- Dergi Adı: Turk Pediatri Arsivi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.107-111
- Anahtar Kelimeler: Etiology, Exchange transfusion, Hyperbilirubinemia, Term newborn, Weight loss
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: The aim of this study is to evaluate the clinical characteristics of term newborns who have had exchange transfusion and identify the etiology of hyperbilirubinemia. Material and Method: This was a retrospective medical chart review. The records of 45 term newborns who were admitted, from January 2002 to December 2006 with the diagnosis of hyperbilirubinemia and had exchange transfusion were reviewed. Exchange transfusion was made according to the guidelines proposed by the American Academy of Pediatrics. Results: A total of 49 exchange transfusions were made in 45 patients. Exchange transfusions were performed twice in two patients and three times in one patient. The gender, gestational age and mean birth weight of infants were 62 % males, 38 % females, 38.7 ± 0.7 weeks and 3237 ± 557 gr (range : 2100-5190 gr) respectively. The proportion of the complaints suggested by the parents were; neonatal jaundice 64.4 % (n:29), feeding difficulties 11.1 % (n:5), respiratory difficulty/dyspnea 6.6 % (n:3) and irritabilty-retrocollis 4.4 % (n:2). At the hospital admission, their mean body weight was 2970 ± 551 gr (range : 1740-5110 gr), mean postnatal age was 4.7 ± 2.5 days (range : 1-13days), and mean total serum bilirubin level was 28.1 ± 7.8 mg/dl (range : 12-46.5 mg/dl). Exchange transfusion was made with in 2.3 ± 1.7 hours (range: 1-5 hours) after admission. Hemolytic disease was found in 55.5 % of the infants (n:25). The most common causes of hemolysis were sensitization to ABO (n:9), Rh (n:6), ABO+Rh (n:2), other blood group antigens (n:2), glucose-6-phosphate dehydrogenase deficiency (n:1), urinary tract infection (n:1), sepsis (n:1) and unknown (n:3). The underlying cause was not identified in 46.6 % (n:21) of cases. Conclusions: This study confirms that half of the causes were not identified in term newborns who had exchange transfusion due to hyperbilirubinemia. The common causes were sensitization to ABO, Rh, other blood group antigens, glucose-6-phosphate dehydrogenase deficiency and sepsis. Excessive weight loss has been high in this group. The need for exchange transfusion could be reduced by following the infant closely after discharge and by educating parents about jaundice.