Biochemical changes during exchange transfusion in hyperbilirubinemia in term newborn babies

Double volume (170 ml/kg body weight) exchange transfusion was done in 52 term infants in the first week of life for neonatal hyperbilirubinemia. The M:F ratio was 1.08:1 and 37 (71.1%) babies were of low birth weight. Causes of jaundice were hemolytic in 46.2% and non-hemolytic in 41.3% cases; in 13.5% babies no cause of jaundice could be found. After exchange transfusion a fall of 14.6% and 47.4% was observed in the hemoglobin and serum bilirubin levels respectively. There was significant (p=0.0414) rise in the mean mid exchange and post-exchange serum sodium levels as compared to pre-exchange values and it was found to be due to higher donor's serum sodium levels (p=0.007). There was no effect on the serum potassium levels during or after ET.In general serum calcium levels significantly increased at mid-exchange period (p=0.0029) but post-exchange levels were same as pre-exchange. Donor's serum calcium level had no effect on the infant's serum calcium level (p=0.993). There was no change in the serum phosphate and blood urea levels during and after exchange-transfusion. The plasma glucose was significantly raised during and after ET and plasma glucose of the donors had significant effect on the infant's plasma glucose levels (p=0.043). Similarly plasma osmolality also showed significant increase during and after ET which was due to the effect of donor's plasma osmolality (p=0.007).