Severe Adverse Events Associated With Exchange Transfusion For Extreme Hyperbilirubinemia

Objective : To investigate the risk factors of severe complications possibly associated with exchange transfusion(ECT)performed for extreme hyperbilirubinemia.Methods:This study included overall 71 neonates who underwent exchange transfusion(ECT)between 2001 and 2018,and suffered severe complications as adverse event group,and the propensity score principle was used to match other 213 neonates(1:3)who underwent exchange transfusion(ECT)but didn’t suffered any severe complications as control group.The demographic characteristics of patients,and other data were recorded.The conditional logistic regression model was constructed to explore the risk factors of exchange transfusion(ECT).Results : Of the 1353 neonates who underwent exchange transfusion(ECT)during the past 18 years,71 neonates(4.6%)were identified with severe adverse events,among which,apnea(30.6%),necrotizing enterocolitis(18.8%),heart failure(14.1%),respiratoryfailure(12.9%),shock(8.2%)were noted commonly.It was demonstrated that ABE score≥3(OR=6.383,95%CI2.550~15.979),ECTs≥2times(OR=11.825,95% CI 2.464~56.755),cardiac murmur≥level III(OR=20.417,95% CI 4.705~40.590)and dramatic blood pressure fluctuation≥30 mm Hg(OR=13.612,95% CI 1.795~43.342)were recognized as risk factors of ET-related severe complications.Conclusion:Severe complications possibly associated with exchange transfusion(ECT)were irreversible.It was crucial to improve perinatal care and prevent extreme hyperbilirubinemia.