Exchange transfusion using high erythrocyte to plasma ratio for severe neonatal hyperbilirubinemia

Objective To investigate the effectiveness and safety of exchange transfusion with high ratio of hemocyte to plasma for treatment of severe neonatal hyperbilirubinemia.Methods A total of 58 neonates with severe hyperbilirubinemia recieved exchange transfusion of erythrocytes and plasma at a ratio of 2—3 to 1.Patients include 27 cases of ABO hemolytic disease,12 cases with Rh hemolytic disease,11 cases of severe infection,2 cases of hereditary spherocytosis,and 6 cases of unknown causes.The total amount of exchange transfusion was 180 ml/kg.Blood cell counts,serum electrolytes,serum bilirubin level and the ratio of total bilirubin / albumin(B/A) were analyzed before and after exchange transfusion.Results There was significant difference,with 50% decrease,in serum bilirubin level,and the ratio of B/A(t=28.334,P0.001;t=9.49,P0.01).White cell counts,platelet counts,and the calcium level decreased after exchange transfusion.The levels of other electrolytes were kept stable.A total of 55 patients were cured,while continuing treatment for the other 3 patients were given up because of the poor neurological outcomes.Conclusion Exchange transfusion is safe and effective for the neonates with severe hyperbilirubinemia.