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Neonatology clinic in Yeshwanthpur, Bangalore

Neonatal Exchange Transfusion

Neonatology clinic in Yeshwanthpur, Bangalore

As premature or sick babies can develop potential medical disorders compared to normal infants, an Exchange Transfusion (ET) procedure is performed in neonates suffering from a variety of blood-related disorders and jaundice. The ET procedure involves removing a portion or aliquot of the baby's blood and replacing it with donor blood. This procedure helps to remove abnormal and toxic blood components from ill infants. 

Why is the ET procedure performed in neonates?

Weak newborns and premature babies require ET treatment as a part of newborn resuscitation for correction of anaemia and removal of antibodies. The ET procedure can be performed by a two-catheter push-pull technique or one push-pull catheter technique. Your child's doctor will consider the baby's size, medical condition, and significant vitals and proceed with either technique accordingly. However, before performing the ET surgery, written parental consent is obtained by the medical department from parents or legal guardians. 

ET procedure is performed in neonates in the following conditions: 

  • Hyperbilirubinemia (higher amount of bilirubin in the blood). 

  • To remove antibodies associated with red blood cell Haemolysis.

  • For correcting anaemia.

  • For treating Neonatal Polycythaemia (high concentration of red blood cells in baby's blood).

  • For treating severe anaemia like Haemolytic Disease of The Newborn (HDN). 

  • For preventing Kernicterus (brain damage caused by high levels of bilirubin in an infant) 

  • Severe sickle cell crisis

  • Severe disturbances in the infant's body chemistry 

The most common reason for performing ET procedures in infants is to treat severe hyperbilirubinemia and alloimmune haemolytic disorders. Once the bilirubin level in the infant's blood is at or above the exchange transfusion level, then neonatal doctors will consider it an emergency and medical procedures are commenced immediately to treat the infant within the right time. Book an appointment to consult with the experts.

Types of Neonatal ET procedures: 

There are various ET procedural types performed on infants. For term infants, the volume of blood for exchange is 80ml/kg (or 70-90ml/kg), and for preterm infants, it is 100 ml/kg (or 85-110 ml/kg). The blood volume for exchange is calculated by using an estimate of the infant's circulating blood volume. 

  • Double volume ET

This ET procedure is commonly used for the removal of bilirubin and antibodies. This double-volume method replaces 85 - 88% of blood volume. Here, if the infant's circulating blood volume is 80 ml/kg, then the volume of blood for exchange will be double, i.e., 160 ml/kg. 

  • Single volume ET

Here, 80 ml/kg is the volume of blood for exchange based on the above example. This single-volume method replaces 60% - 65% of blood volume. This method is performed in cases other than the Haemolytic Disease of The Newborn (HDN). 

  • Partial ET

While in sickle cell anaemia, the infant's damaged blood is removed and replaced with donor blood; in conditions like neonatal polycythaemia, a partial ET procedure is performed. This method involves removing an aliquot or portion of an infant's blood and replacing it with normal saline, plasma or albumin. As a result, the number of red blood cells in the infant's blood decreases, thereby making it easier for the blood to flow throughout the body. Visit our neonatology hospital in Yeshwanthpur for the best treatment.

Complications and risks: 

Neonatal experts will thoroughly test and examine the donor's blood before performing the ET procedure. Your baby is made comfortable, and the ET procedure is performed by slowly withdrawing the infant's blood and replacing it with an equal amount of fresh donor blood. This transfusion cycle is repeated until the right blood volume is replaced properly. While the common transfusion risks are possible, here are some of the other potential risks: 

  • Hyperthermia 

  • Arrhythmias

  • Blood clots, heart and lung problems

  • Shock

  • Neutropenia

  • Septicaemia

  • Bradycardia

Experience world-class healthcare at Manipal Hospitals. Our expert team of doctors and state-of-the-art facilities ensure personalized and advanced treatments. Take the first step towards wellness. Book an appointment today.

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