Assessment of newborn infants with exchange transfusion due to indirect hyperbilirubinemia: Single center experience

Objective: Neonatal hyperbilirubinemia is a frequently seen clinical condition, and bilirubin encephlopathy is presetly an important health problem. In our study the patients who had undergone blood exchange transfusion were evaluated as for responsible etiologic factors, complications developed due to blood exchange transfusion and development of bilirubin encephalpathy. Methods: Between January 2012 and January 2015, infants who were admitted to Izmir Tepecik Training and Research Hospital due to hyperbilirubinemia and underwent exchange transfusion were retrospectively investigated. Demographic data, laboratory parameters, exchange complications and the frequency of development of bilirubin encephalopathy were investigated. Cases with bilirubin encephalopathy were compared with non-encephalopathic ones as for the presence of risk factors. Results: Twenty-seven infants were included into the study and 59.3% of the cases were male and 55.6% of them were born with caesarean section. The mean gestational age of the infants was 36.5 +/- 3.1 weeks and their mean birth weight was 2912.5 +/- 759 grams. The mean age at the time of admission was 34.2 +/- 54.2 hours and 81% of infants had exchange transfusion within the first 24 hours due to ABO incompatibility in 40.7% and Rh incompatibility in 33% of the infants. Total bilirubin and platelet counts decreased after exchange transfusion, leading to a statistical difference (p<0.05). The most common complications were hypocalcemia (14%), thrombocytopenia (7%), and hypoglycemia (7%). Neurological effects of bilirubin encephalopathy were detected in 25.9% of the cases but there was no statistical difference in terms of demographic, etiologic and laboratory data when compared with those without neurologic involvement. Conclusion: Though ABO, and Rh incompatibilities are the most frequently seen causes of blood exchange transfusions, the frequency of blood exchange transfusions may be decreased by preventing early discharges, informing the families, and close follow-up after discharge.