Clinical Retrospective Analysis Of Term Infants With Exchange Transfusion

ObjectiveTo investigate the causes and the risk factors of hyperbilirubinemia,the adverse reactions of exchange transfusion, the risk factors of poorprognosis.MethodsRetrospective analysis was carried out on the clinical data of609fullterm neonates admitted Children Hospital of Chongqing MedicalUniversity and accepted exchange transfusion treatment forhyperbilirubinemia from January2001to December2011.ResultOf all the609cases, the mean gestational age was (39.1±2.6) weeks,the onset time of jaundice was (35.5±22.6)hours，the mean age whenadmitted was (84.1±40) hours, the highest bilirubin was (455.2±117.8)μmol/L.361(59.3%) neonates had acute bilirubinencephalopathy(ABE),44(7.2%)had poor prognosis. The most commoncause of hyperbilirunemia was ABO incompatibility(60.9%), followed byaetiology unknown(96,15.8%), which13.5%(13) neonates with hyperbilirubinemia myght is due to excessive weight loss. The majority ofadverse events associated with ET was thrombocytopenia. The incidencerate of serious adverse events associated with ET is7.2%, and the mostcommon serious adverse events associated with ET was apnea. No case ofET-ralated mortality was observed. The cause of hyperbilirubinemia, thepeak bilirubin before ET and the time of ET had a significant effect onprognosis of jaundice infants.ConclusionThe most common cause of hyperbilirubinemia was ABOincompatibility. Physician should pay attention to neonatal feeding andweight change for the idiopathic jaundice, because excessive weight losswas the only cause of hyperbilirubinemia. The majority of adverse eventswith ET was hematology laboratory test report abnormal, which wasreversihle. However, serious adverse events might occur no matter howmuch illness the infant was. The worse the neonatal condition was, thegreater incidence of serious adverse events was. The cause ofhyperbilirubinemia, the peak bilirubin before ET and the time of ET had asignificant effect on prognosis of jaundice infants. If TSB had reached thestandard of ET, ET should be carried out immediately.