HYPERBILIRUBINEMIA IN PREMATURE-INFANTS - RELEVANCE TO BLOOD-TRANSFUSION

The rate of hemolysis of transfused adult red blood cells in the prema ture circulation may be higher than in the native circulation and prod uce a significant bilirubin load on the immature liver during the firs t days of life with consequent hyperbilirubinemia. The association bet ween the transfusion of packed red blood cells and consequent change o f serum bilirubin level was evaluated in 35 premature infants with bir th weight of <1,250 g during the first 10 days of life, using the anal ysis of variance method. There was a significant increase of bilirubin level with a mean of 24.3 mu mol/l following packed red blood cells t ransfusion. Birth weight had a significant negative effect and mechani cal ventilation for >2 days had a significant positive effect on bilir ubin levels; however, the changes were of small magnitude. The results of our study indicate that a rise of bilirubin level following blood transfusion to very low birth weight infants during the early neonatal period should be anticipated.