期刊
TROPICAL DOCTOR
卷 51, 期 2, 页码 146-150出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0049475520959731
关键词
Exchange transfusion; hyperbilirubinaemia; India; neonates; neonatal intensive care unit
This descriptive study examines the clinical profile of neonates who underwent exchange blood transfusion and identifies potential management gaps, such as early discharge, incomplete blood grouping, and lack of immunoprophylaxis. Major risk factors for severe hyperbilirubinemia include Rh iso-immunisation, ABO iso-immunisation, and sepsis.
Our descriptive study examines the clinical profile of referred neonates who underwent exchange blood transfusion (EBT) and identifies possible interventions at peripheral hospitals to decrease their severe hyperbilirubinemia. Among the 38 neonates enrolled, the following were identified as potential clinical gaps in management: early discharge within 24 h of birth (57%); non-availability of ABORh blood grouping (43%); lack of anti-D immunoprophylaxis (75%); pathological weight loss because of inadequate breastfeeding (42%); and low usage of phototherapy. Because of late recognition, the mean age at admission was 5.4 +/- 3.3 days, levels of total serum bilirubin (TSB) were 516.4 +/- 123.1 mu mol/L, and acute bilirubin encephalopathy (ABE) was seen in 45% of neonates. Rh iso-immunisation (39.5%), ABO iso-immunisation (21%) and sepsis (8%) were major risk factors for severe hyperbilirubinaemia. Quality prenatal screening identifying at-risk newborns, preventing early discharge after birth, a bilirubin nomogram risk assignment before discharge and assuring early recognition of hyperbiliubinaemia by parents may well minimise the incidence of EBT.
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