Abstract
In infants of VLBW with severe RDS, in spite of supportive care including ventilation and ET, mortality remains high. The purpose of this study is to report the therapeutic benefits achieved by employing ET with fresh blood anticoagulated with citrate phosphate dextrose and allowed to “settle” to an Hct. of 55-60%. Thirty-nine infants 750-1100 gms. with severe RDS requiring an FiO2 > 60% for PaO2 ≥ 60 mmHg within the first few hours of life were divided into 2 groups matched for weight and gestational age. All infants received supportive care including ventilation. Group I consisted of 20 infants 991 ± 104 g. who were exchanged within the first 8 hrs. of life with settled cells in addition to receiving supportive care. Group II consisted of 19 infants 929 ± 118 g. who served as controls. Mean hematocrit prior to exchange transfusion was 45 ± 1.86% and increased to 51 ± 1.9% post ET (p < 0.03). In non-exchanged infants the hematocrit was maintained at 45 ± 2.9% with boost transfusions. Twelve out of 20 infants exchanged survived (60%) while there was only 1 (5%) survivor in the non-exchanged group. These results indicate that early exchange transfusion with settled cells presumably by improved tissue oxygenation, increases the survival rate of VLBW infants with severe RDS and is a useful adjunct to supportive therapy.
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Anday, E., Sacks, L., Kumar, S. et al. 929 THE ROLE OF EXCHANGE TRANSFUSION (ET) WITH SETTLED CELLS ON ALTERING MORTALITY IN VERY LOW BIRTH WEIGHT (VLBW) INFANTS < 1100 GMS WITH SEVERE RESPIRATORY DISTRESS SYNDROME (RDS) AT BIRTH. Pediatr Res 12 (Suppl 4), 518 (1978). https://doi.org/10.1203/00006450-197804001-00934
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DOI: https://doi.org/10.1203/00006450-197804001-00934