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Exchange Transfusion

Exchange Transfusion in Newborns: A Lifesaving Procedure

Exchange transfusion is a critical medical procedure performed in newborns to treat severe conditions like neonatal jaundice, hemolytic disease of the newborn (HDN), and certain metabolic disorders. This procedure involves gradually replacing the infant's blood with donor blood to remove harmful substances and restore normal blood composition..

Why is Exchange Transfusion Needed?

Exchange transfusion is primarily used for:

  • Severe neonatal jaundice caused by high bilirubin levels, which can lead to kernicterus.
  • Hemolytic disease of the newborn (HDN) due to Rh or ABO incompatibility, where maternal antibodies destroy the baby’s red blood cells.
  • Neonatal sepsis with severe acidosis or toxic substances.
  • Sickle cell disease complications in newborns requiring rapid blood exchange.

How is Exchange Transfusion Performed?

The procedure is done in a neonatal intensive care unit (NICU) under sterile conditions. A catheter is inserted into a major blood vessel, and small volumes of the baby’s blood are slowly removed and replaced with matched donor blood. This gradual process helps stabilize the baby’s condition while avoiding sudden blood pressure changes.

Risks and Complications of Exchange Transfusion

Although life-saving, exchange transfusion has potential risks, including:

  • Electrolyte imbalances
  • Infection risks
  • Blood clotting issues
  • Bradycardia (slow heart rate)
  • Hypoglycemia or hypocalcemia

Post-Procedure Care

After exchange transfusion, newborns require close monitoring for:

  • Oxygen levels and vital signs
  • Signs of anemia or recurrent jaundice
  • Blood glucose and calcium levels
  • Prevention of infections

Exchange transfusion remains a crucial treatment for newborns with severe blood-related disorders. With advances in neonatal care, early diagnosis and timely intervention can significantly improve outcomes. Pediatric specialists ensure that this procedure is performed safely, offering newborns a better start to life.

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