Comparative study between the Usage of Whole Blood and Whole Blood Reconstituted in Neonatal Hyperbilirubinemia in Exchange Transfusion

Anitha, T (2020) Comparative study between the Usage of Whole Blood and Whole Blood Reconstituted in Neonatal Hyperbilirubinemia in Exchange Transfusion. Masters thesis, The Tamilnadu Dr.M.G.R. Medical University, Chennai.


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INTRODUCTION: Neonatal hyperbilirubinemia is an ongoing problem that requires medical attention and hospital readmission in newborns and approximately 5-10 percent of all newborns require intervention for pathologic jaundice. Exchange Transfusion (ET) is an effective emergency intervention to lower the bilirubin levels in neonates at high risk of bilirubin encephalopathy. AIM OF THE STUDY: To evaluate the efficacy of whole blood and whole blood reconstituted used in Exchange Transfusion (ET) in Neonatal Hyperbilirubinaemia (NNH) due to HDFN. MATERIAL AND METHODS: Total 40 neonates with ABO and Rh Hemolytic Disease of Fetus and newborn were included in this study and Exchange Transfusion was carried out in both groups either by Whole Blood or Whole Blood Reconstituted selected by randomization. RESULTS: In the present study, the efficacy of exchange transfusion between fresh whole blood and whole blood reconstituted among 20 Neonatal cases of Hyperbilirubinemia each revealed improvement in Haemoglobin and fall in bilirubin level in 7 out of 14 cases of ABO HDFN with WB and in all 8 cases of ABO HDFN with WBR. We observed improvement in haemoglobin level and fall in serum bilirubin in all cases of Rh HDFN in both groups where “O Rh Negative Whole Blood” and O Rh Negative Red Cells with AB Plasma from male donors with no prior history of blood transfusion was used.(Whole Blood Reconstituted). CONCLUSION: In our study, we observed better outcome with whole blood reconstituted than whole blood alone exchange transfusion in bringing back desired level of haemoglobin and serum bilirubin in cases of ABO HDFN. In cases of Rh HDFN there is no difference between WBR and WB exchange transfusion. However, to avoid failure to achieve desired results in cases of ABO HDFN using O Whole blood exchange transfusion, as a preventive measure it is essential to use “O Whole Blood” with titre less than critical level.Further, to avoid unexpected exposure to anti-D in cases of Rh HDFN WBR exchange transfusion, it is necessary to use AB plasma only from male donors without the history of prior transfusion.

Item Type: Thesis (Masters)
Additional Information: 201731001
Uncontrolled Keywords: Hyperbilirubinemia, Jaundice, Exchange Transfusion.
Subjects: MEDICAL > Immunohaematology Blood Transfusion
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 16:21
Last Modified: 05 Feb 2021 16:22

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