Exchange blood transfusion: Its metabolic and cardiorespiratory effect in newborns

Abstract

Introduction: Neonatal jaundice constitutes 20% of admissions, and kernicterus is seen in 8% of cases while mortality rate of 6% has recorded across centers in Nigeria. There are various modalities for the management of neonatal hyperbilirubinemia including exchange blood transfusion (EBT). This study seeks to determine blood glucose and vital signs changes associated with EBT. Materials and Methods: The study was cross-sectional; carried out at the Special Care Baby Unit of Aminu Kano Teaching Hospital, Kano. Neonates requiring EBT from unconjugated hyperbilirubinemia were recruited. Results: There were 20 neonates enrolled, 18 (90%) males and 2 (10%) females with male to female ratio of 9:1. The turnaround time ranged from 3 to 31 h with mean value of 10.4 ± 7.9 h; however, most of the neonates (60%) had EBT more than 5 h after presentation. The mean temperature before EBT was 36.9°C ± 0.4°C; while after EBT, it was 36.2°C ± 0.5°C, and no case of hypothermia was documented. The mean respiratory rate before EBT was 46.3 ± 5.2 cycles/min; while after EBT, it was 51.9 ± 9.1 cycles/min; with no record of apnea. Mean heart rate was 143.8 ± 7.1 beats/min before the procedure and was 145 ± 15 beats/min after EBT. The mean serum glucose concentration before EBT was 4.5 ± 2.7 mmol/L, while it was 4.9 ± 2.2 mmol/L after EBT. Conclusion: Our study documented higher respiratory and heart rates post procedure with no record of apnea; furthermore, the serum sugar remained normal post-EBT.