Analysis Of Effect Of Exchange Transfusion On Neonates With Severe Hyperbilirubinemia

Objective:To investigate the etiology of severe hyperbilirubinemia in neonates and to analyze the effects of exchange transfusion on newborns with severe hyperbilirubinemia and the safety of exchange transfusion.Method:1.For newborns recruited to the study,the specimens were tested for the etiology of severe hyperbilirubinemia.2.Serum total bilirubin,indirect bilirubin,direct bilirubin,total protein,albumin,white blood cell,hemoglobin,hematocrit,platelet,serum potassium ions,sodium ions,chloride ions,total calcium and pH value were measured before and after ET.3.Adverse reactions were observed and recorded during ET.Result:1.The common causes of severe hyperbilirubinemia in newborns are bact-erial infection,genetic glucose-6-phosphate dehydrogenase deficiency,and hemolytic disease of newborn with ABO blood type incompatibility,accounting for 28.2%,27.5%,and 16.2%,respectively.2.Before ET,the total bilirubin,indirect bilirubin,direct bilirubin,total protein and albumin were(487.9±133.1)?mol/L,(462.6±127.0)?mol/L,(25.3±13.2)?mol/L,(54.0±5.7)g/L,(34.3±3.5)g/L respectively,while after ET they were(221.8±77.7)?mol/L,(206.1±75.7)?mol/L,(15.8±8.1)?mol/L,(45.1±4.4)g/L,(28.1±2.9)g/L respectively.All of them were obviously reduced after ET(P<0.05).The replacement rate of total bilirubin was 54.4%on average.3.Before ET,the white blood cell count,hemoglobin concentration,hematocrit and platelet count were(14.1±6.5)×10~9/L,(138.5±28.2)g/L,(0.424±0.080),(291±103)×10~9/L respectively,while after ET they were(6.0±2.9)×10~9/L,(124.0±19.7)g/L,(0.378±0.050),(75±32)×10~9/L,respectiv-ely.There was an obvious decrease in them after ET(P<0.05).4.Before ET,serum potassium ions,serum sodium ions,serum chloride ions,serum total calcium and pH value were(4.20±0.53)mmol/L,(140.5±9.3)mmol/L,(103.7±8.8)mmol/L,(2.39±0.19)mmol/L,(7.42±0.08)respectively,while after ET they were(4.30±0.68)mmol/L,(140.5±11.1)mmol/L,(102.5±3.6)mmol/L,(2.21±0.22)mmol/L,(7.38±0.05),respectively.There is no difference in serum potassium ions,sodium ions and chloride ions between pre-ET and post ET(P>0.05),but the total calcium and pH values decreased significantly(P<0.05).5.There were 5 cases with adverse reaction observed in the study:2 cases with cardiorespiratory arrest,1 case with respiratory distress,and 2 cases with secondary exchange transfusion.The incidence of adverse reaction was about 3.5%.Conclusion:1.The causes of severe hyperbilirubinemia in newborns were mainly bacterial infection,G6PD deficiency and ABO-HDN.2.ET can remove excessive bilirubin in the blood.3.ET has an effect on the total protein,albumin,white blood cell count,hemoglobin concentration,hematocrit,platelet count,total calcium and pH value.4.ET has a certain risk.