ADMINISTRATION OF ALBUMIN IN THE MANAGEMENT OF HYPERBILIRUBINEMIA BY EXCHANGE TRANSFUSIONS

Abstract

A comparative study was done to evaluate the effect of the administration of albumin on the removal of bilirubin by exchange transfusion. The amounts of bilirubin removed by simple exchange were similar when the pre-exchange concentrations in serum were alike. The administration of one gram of albumin per kilogram of body weight 1 to 2 hours prior to the procedure resulted in the removal by exchange transfusion of an average of 41% more bilirubin per kilogram of birth weight. The amount of bilirubin removed from the infants given albumin did vary from infant to infant in spite of similar pre-albumin bilirubin concentrations in serum. This was interpreted to represent variation in the total body bilirubin content, even when serum levels are alike. The amount of bilirubin removed per kilogram of birth weight was not found to be related to the etiology of the hyperbilirubinemia, the infant's age, or to the body weight at the time of the exchange. The albumin administration was associated with an increase in bilirubin concentration in serum and a decrease in capillary hematocrit value. Adipose tissue did not seem to be a major source of the additional bilirubin removed.