A retrospective study of exsanguinotransfusion of newborns with reconstituted blood. A review of 60 exchanges.

A retrospective study of exsanguinotransfusion of newborns with reconstitut ed blood. A review of 60 exchanges. Purpose - The necessity of saving blood products has established the practi ce of exchange transfusion (ET) with reconstituted blood in newborns. The a im of this retrospective study was to evaluate the indications and the prac tice of this technique at the Perinatal Hemobiology Centre (Paris, France). Methods - The records of intervention allowed us to review the etiologic ca tegories for neonates having undergone exchange transfusion with reconstitu ted blood, the dosages used (bilirubin, hemoglobin), and the other main par ameters of ET. Results - Sixty ETs were performed in 48 newborns between the 1st July 1996 and the 1st July 1998. Twenty-seven with Ph hemolytic disease had 39 ETs ( 19 for hyperbilirubinemia, 12 for anemia, and eight for both), whereas ten out of 12 repeated ETs were indicated for hyperbilirubinemia (six of these cases were in newborns weighing greater than or equal to 2500 g and after a volume exchange less than or equal to 1 blood mass [range 0.72-1.0] at the last ET). Twenty-one cases showed other diseases: six of them had anemia, nine had hyperbilirubinemia, and seven showed disseminated coagulopathy. Th e tolerance of ET was poor in 24% infants in this group. Conclusions - The volume of 1.3 blood mass for ET is sufficient for the maj ority of cases with hyperbilirubinemia, allowing transfusional savings in c omparison with the previous recommendation of two blood volumes. Exact labe ling of the content of units of packed red cells and plasma is essential to fulfill the volume and hematocrit requirements in every case. (C) 1999 Els evier, Paris.