Abstract
Double volume exchange transfusions (ET) in neonates are generally used to reduce serum bilirubin concentrations and also provide fresh albumin to enhance bilirubin-albumin binding. This would be expected to reduce the circulating unbound bilirubin (UB). We measured serum total bilirubin (TB), UB, albumin (Alb) and HABA binding sequentially at quarterly intervals (of total blood volume exchanged) and at 4, 24, and 48 hours post exchange in 9 double volume ET, assuming the infant's blood volume to be 80 ml/kg b.wt. TB and UB were measured by the new automated peroxidase micromethod with the UB analyzer UA-1 (Lobo Science USA-Inc.).
Results: TB and UB decreased, while albumin and HABA-binding increased with increasing volume of blood exchanged. Maximal changes occurred during the first quarter of the exchange transfusion. Sequential mean percent changes were:
The mean aggregate reduction for TB and UB was 40 and 70% respectively. Mean aggregate increment for albumin and HABA-binding was 29 and 128% respectively. The UB Analyzer UA-1 can provide rapid information on the efficiency of exchange transfusion and status of protein-anion complex.
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Ananda, A., Wu, YS. & Wu, P. 1322 CHANGES IN SERUM TOTAL AND UNBOUND BILIRUBIN, ALBUMIK AND HABA BINDING DURING DOUBLE VOLUME EXCHANGE TRANS FUSION. Pediatr Res 19, 331 (1985). https://doi.org/10.1203/00006450-198504000-01346
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DOI: https://doi.org/10.1203/00006450-198504000-01346