Related Experiment Video

Updated: Jun 8, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
05:23

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Excessively high bilirubin and exchange transfusion in very low birth weight infants

Jacob Kuint1, Ayala Maayan-Metzger, Valentina Boyko

  • 1Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Tel Aviv University, Israel. kuint-j@sheba.health.gov.il

Acta Paediatrica (Oslo, Norway : 1992)
|September 18, 2010
PubMed

Insights

Exchange transfusion was rarely used in very low birth weight infants with high bilirubin levels, suggesting a need for clearer guidelines. This impacts treatment decisions for neonatal jaundice.

Area of Science:

  • Neonatalogy
  • Pediatric Hematology
  • Clinical Performance Evaluation

Background:

  • Very low birth weight (VLBW) infants are susceptible to hyperbilirubinemia.
  • High bilirubin levels pose a risk of neurological damage.

Purpose of the Study:

  • To assess the utilization of exchange transfusion in VLBW infants with excessively high bilirubin levels.
  • To analyze factors influencing exchange transfusion decisions.

Main Methods:

  • Population-based observational study using the Israel National VLBW Infant Database.
  • Included 13,499 infants.
  • Defined high bilirubin thresholds as ≥15 mg/dL (PSB-15) or gestational age-dependent levels (PSB-GA).

Main Results:

  • 3.5% (PSB-15) and 7.7% (PSB-GA) of infants exceeded bilirubin thresholds.
  • Exchange transfusion was performed in only 9-14% of eligible infants.
  • Peak serum bilirubin was an independent factor for performing exchange transfusion.

Conclusions:

  • Exchange transfusion is underutilized in VLBW infants with dangerously high bilirubin levels.
  • This may stem from unclear guidelines or concerns about transfusion risks versus neurological injury risks.
Abstract

More Related Videos

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt12:27

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Published on: May 7, 2015

Related Concept Videos

Jaundice01:25

Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
Blood Transfusion and Agglutination02:45

Blood Transfusion and Agglutination

Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
Transcytosis of IgG01:15

Transcytosis of IgG

Transcytosis is the process in which molecules are internalized by endocytosis, transported across the cell, and released through exocytosis from the opposite end of the cell. Molecules such as insulin, immunoglobulins, and certain nutrients are transferred through the recycling endosomes by recycling and transcytosis.
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
Lifecycle of Erythrocytes01:22

Lifecycle of Erythrocytes

Erythrocytes, also known as red blood cells, constantly move through blood capillaries. As a result, they damage their plasma membrane due to the continuous friction. Typically, after 100 to 120 days, erythrocytes become rigid and fragile as they wear out. As they pass through small vessels in the spleen and liver, they can get trapped and break apart into fragments.
The resident phagocytic macrophages deal with these damaged cells by engulfing them and separating their globin and heme groups.
Blood Transfusion01:15

Blood Transfusion

Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...