BLOOD EXCHANGE TRANSFUSION

 BLOOD EXCHANGE TRANSFUSION

This is a treatment in which the baby’s blood is gradually removed and replaced by donor’s blood. It is used as a definitive treatment when bilirubin concentrations are approaching toxic levels. The baby has haemolyticdisease  or low Hb. The transfusion has the following benefits

-it helps in increasing the baby’s Hb

-excessive bilirubin and unwanted antibodies are washed from the babys circulation.

The donor’s blood used for the transfusion should be rhesus negative so that it does not alter the babys blood group and to ensure that no antigen ios introduced into the baby’s circulation that may lead to antibodies production. It should also be fresh and ABO compactible.

Indications

ü Infants with haemolytic disease.

ü Preterms with bilirubin levels of 300 -400 mol/l

ü Babies whose birth weight was less than 1500g and have bilirubin levels of 255mol/l

ü Term babies with bilirubin levels above 100 mol/l at birth or later 400 -500 mol/l

Care of the baby post transfusion

ü Put the baby back to phototherapy to continue with it.

ü Closely observe the baby for bleeding from the umbilical cord.

ü If the baby was on infusion, continue for some time.

ü Reassure the mother and involve her in the care of the baby.

Complications

ü Circulatory collapse

ü Incompatibility reactions

ü Acquired infections e.g. HIV, hepatitis B.

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