LQCL2518 - CMLE - Exchange Transfusion as an Emergency Treatment for Hyperbilirubinemia for Hemolytic Disease of the Newborn-LQCL2518

LQCL2518 - Educational Activity

Pdf Summary

The document outlines comprehensive information on Hemolytic Disease of the Fetus and Newborn (HDFN), primarily focusing on the role of exchange transfusion in managing this condition. It starts with learning objectives, such as defining key terms, including immune hyperbilirubinemia and exchange transfusion, identifying clinical indications for exchange transfusions, and recognizing potential complications.<br /><br />A case study of a neonate experiencing severe jaundice due to HDFN is presented. The infant, born to an O negative mother, tested B positive, displaying significant hyperbilirubinemia. Despite phototherapy, bilirubin levels continued to rise, necessitating an intravenous immunoglobulin (IVIG) and ultimately a double volume exchange transfusion (DVE). The procedure involved using reconstituted whole blood to rapidly lower bilirubin levels and prevent kernicterus—a form of brain damage. The blood product selection critically includes O negative packed red cells and group AB fresh frozen plasma.<br /><br />The document explains that exchange transfusion helps reduce maternal antibodies, correct anemia, and manage conditions like G6PD deficiency or sepsis. It delves into blood group antigens, noting that RhD antigen is a severe cause of HDFN, with others like ABO causing milder forms. Additionally, it provides methods such as ultrasound and blood sampling for prenatal HDFN prediction.<br /><br />Neonatal blood bank testing practices, including ABO grouping and crossmatching recommendations, are discussed. Management includes phototherapy as first-line treatment, with IVIG as an alternative to delay exchange transfusion. DVE aims to replace about 86% of blood, reducing bilirubin levels significantly.<br /><br />In summary, the document underscores the critical role of timely exchange transfusion to manage severe neonatal jaundice and prevent adverse outcomes like kernicterus, aided by effective collaboration among healthcare providers and meticulous blood product selection.

Keywords

Hemolytic Disease of the Fetus and Newborn

exchange transfusion

immune hyperbilirubinemia

kernicterus

neonatal jaundice

IVIG

O negative blood

RhD antigen

phototherapy

blood bank testing