Vásquez-Hoyos P, Romero H, Álzate JP, Riaño LH, Góngora MM, Roa RA

Language: Spanish
References: 17
Page: 91-96
PDF size: 231.99 Kb.

ABSTRACT

Introduction: Neonatal jaundice is a frequent pathology, which can have different degrees. Currently, the factors associated with severe hyperbilirubinemia are known, but not for the performance of exchange transfusion. Objective: To identify factors associated with exchange transfusion in jaundiced neonates, in Bogotá, Colombia. Material and methods: Retrospective case-control study. The cases were neonates who required exchange transfusion and the controls were icteric neonates without this procedure. Both groups were matched by sex, gestational age, birth weight, and type of blood incompatibility. Between both groups, demographic and clinical characteristics were compared. Risk factors were estimated using a logistic regression model. Results: Fifty cases and 198 controls were included. The exchange transfusion rate was 85 per 100,000 newborns. The variables associated to exchange transfusion were: supplementary feeding (OR 5.66 [95% CI; 1.25-25.67]), lower hematocrit levels (OR 0.88 [95% CI; 0.83-0.93]) and sepsis (OR 4.04 [IC 95 %; 1.21-13.5]). Conclusion: In this population, there was a high frequency of exchange transfusions. Our findings can help to identify, in a timely manner, infants at higher risk.

REFERENCES

1. Maisels MJ. Physiologic and pathologic jaundice: the conundrum of defining normal bilirubin levels in the newborn. Pediatrics. 2006; 118(2): 805-807.

2. Johnson LH, Bhutani VK, Brown AK. System-based approach to management of neonatal jaundice and prevention of kernicterus. J Pediatr. 2002; 140(4): 396-403.

3. Newman TB, Liljestrand P, Escobar GJ. Infants with bilirubin levels of 30 mg/dL or more in a large managed care organization. Pediatrics. 2003; 111(6 Pt 1): 1303-1311.

4. Newman TB, Liljestrand P, Escobar GJ. Combining clinical risk factors with serum bilirubin levels to predict hyperbilirubinemia in newborns. Arch Pediatr Adolesc Med. 2005; 159(2): 113-119.

5. Bhutani VK, Meng NF, Knauer Y, Danielsen BH, Wong RJ, Stevenson DK et al. Extreme hyperbilirubinemia and rescue exchange transfusion in California from 2007 to 2012. J Perinatol. 2016; 36(10): 853-857. doi: 10.1038/jp.2016.106.

6. Flaherman VJ, Kuzniewicz MW, Escobar GJ, Newman TB. Total serum bilirubin exceeding exchange transfusion thresholds in the setting of universal screening. J Pediatr. 2012; 160(5): 796-800.e1.

7. Bujandric N, Grujic J. Exchange transfusion for severe neonatal hyperbilirubinemia: 17 years’ experience from Vojvodina, Serbia. Indian J Hematol Blood Transfus. 2015; 32(2): 208-214. doi: 10.1007/s12288-015-0534-1.

8. Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999; 103(1): 6-14.

9. Ballot DE, Rugamba G. Exchange transfusion for neonatal hyperbilirubinemia in Johannesburg, South Africa, from 2006 to 2011. Int Sch Res Notices. 2016; 1-5. doi: 10.1155/2016/1268149.

10. Davutoğlu M, Garipardiç M, Güler E, Karabiber H, Erhan D. The etiology of severe neonatal hyperbilirubinemia and complications of exchange transfusion. Turk J Pediatr. 2010; 52(2): 163-166.

11. Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics. 1998; 101(6): 995-998.

12. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004; 114(1): 297-316.

13. Gamaleldin R, Iskander I, Seoud I, Aboraya H, Aravkin A, Sampson PD et al. Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia. Pediatrics. 2011; 128(4): e925-e931. doi: 10.1542/peds.2011-0206.

14. Eggert LD, Wiedmeier SE, Wilson J, Christensen RD. The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics. 2006; 117(5): e855-e862.

15. Kuzniewicz MW, Escobar GJ, Newman TB. Impact of universal bilirubin screening on severe hyperbilirubinemia and phototherapy use. Pediatrics. 2009; 124(4): 1031-1039.

16. Jonguitud-Aguilar J, Noyola-Salazar CA, De Jesús-Raya E, Montes-Acuña OJ. Detección de ictericia neonatal durante la visita para tamiz metabólico neonatal. Rev Mex Pediatr. 2018; 85: 212-215.

17. Mah MP, Clark SL, Akhigbe E, Englebright J, Frye DK, Meyers JA et al. Reduction of severe hyperbilirubinemia after institution of predischarge bilirubin screening. Pediatrics. 2010; 125(5): e1143-e1148.