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  • Title: Two-stage single-volume exchange transfusion in severe hemolytic disease of the newborn.
    Author: Abbas W, Attia NI, Hassanein SM.
    Journal: J Matern Fetal Neonatal Med; 2012 Jul; 25(7):1080-3. PubMed ID: 21919551.
    Abstract:
    OBJECTIVE: Evaluation of two-stage single-volume exchange transfusion (TSSV-ET) in decreasing the post-exchange rebound increase in serum bilirubin level, with subsequent reduction of the need for repeated exchange transfusions. METHODS: The study included 104 neonates with hyperbilirubinemia needing exchange transfusion. They were randomly enrolled into two equal groups, each group comprised 52 neonates. TSSV-ET was performed for the 52 neonates and the traditional single-stage double-volume exchange transfusion (SSDV-ET) was performed to 52 neonates. RESULTS: TSSV-ET significantly lowered rebound serum bilirubin level (12.7 ± 1.1 mg/dL), compared to SSDV-ET (17.3 ± 1.7 mg/dL), p < 0.001. Need for repeated exchange transfusions was significantly lower in TSSV-ET group (13.5%), compared to 32.7% in SSDV-ET group, p < 0.05. No significant difference was found between the two groups as regards the morbidity (11.5% and 9.6%, respectively) and the mortality (1.9% for both groups). CONCLUSION: Two-stage single-volume exchange transfusion proved to be more effective in reducing rebound serum bilirubin level post-exchange and in decreasing the need for repeated exchange transfusions.
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