0165
AN AUTOMATED PERIPHERAL TWO-SITE METHOD FOR NEONATAL
EXCHANGE TRANSFUSION IN CHINA Zhu XY, Huang HW, Zheng LP, Huang RD Maternal and Child Health Hospital, Zhuhai, Guangdong,
China Objective: Automated
exchange transfusion (ET) has been reported abroad, but not yet in China.
To overcome the disadvantages of conventional "push-pull" method,
an automated peripheral two-site method with handiness and fluency for
neonatal ET was developed. Methods: 9
infants of severe hyperbilirubinemia with serum bilirubin (SB) >30 mg/dl
(8 for G-6-PD deficiency, 1 for Rh hemolysis) were in this group. The 24G
in-dwelling cannula with Y adapter was inserted into peripheral vein for
blood-in or artery for blood-out. The artery blood flowed into a measuring
cylinder naturally through a drainage tube with a controller keeping a flow
rate ≯ 4ml/min, which also
received continually a bypass heparin solution through a infusion pump B at
a 30ml/h rate for fear of clotting and blocking in the drainage tube.
Simultaneously the citrated blood was replaced through a pump A at a rate
equal to blood-out rate. The whole procedure no longer handed needed
"push-pull" action, but proceeded automatically in a close loop.
So it became simpler, safer and easier. Results: The
monitored vital signs (blood pressure, heart rate, etc) in ET were normal
and stable. The mean spent time was 2.5 hours. Compared with pre-exchanges,
the mean SB declined by 45.6% (523.8μmol/L→284.8μmol/L), and Hb rose
by 58.6% (87g/L→138g/L).
After exchanges only 3 had mild complications, and no infections and
necrotizing enterocolitis occurred. The follow-up in half a year showed all
normally in growth and development. Conclusion: Our
automated ET was superior to conventional one in handling and effects with
a little different setting from abroad. It could be adopted in most
hospitals at different levels. Still it should be avoided to broaden the ET
indications at will and cause an "over-therapy".