Short-term complications associated with exchange transfusion in neonates with severe hyperbilirubinemia

Neonatal jaundice is a common condition among neonates in the first few days of life and is a leading cause of admission among neonates. The aim of this study was to investigate the most common risk factors associated with severe neonatal hyperbilirubinemia (NNH) and short-term complications of the exchange transfusion (ET).

In this retrospective study, the medical records of newborns <28 days with severe hyperbilirubinemia who underwent ET during 2015-2018 were analyzed. Medical records and files were searched using the keyword “exchange transfusion”. The clinical and demographic characteristics of the study population as well as the short-term complications of ET were descriptively analyzed.

Totally, 74 newborns with the mean age of 5.6 ± 3.4 days were included in the current study. The baseline mean peak total serum bilirubin (TSB) was 25.8 ± 5.7 mg/dl.  In neonates, the ABO incompatibility was the most frequent cause of severe hyperbilirubinemia requiring ET (54.1%), followed by sepsis (39.2%). Moreover, 57.7% of neonates developed complications secondary to ET. The most common complication was hyperglycemia (71.6%), followed by thrombocytopenia (48.6%).

Hemolysis and sepsis are common causes of NNH; therefore, the extensive screening and identification of the at-risk population can help decrease the incidence of severe NNH. Frequent monitoring of blood sugar and screening of thrombocytopenia before and after ET procedures are necessary to reduce adverse events.