Page 454 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Exchange transfusion

Bibliographic Study Type & Number of Intervention & Comparison Dichotomous outcomes Continuous Outcomes Comments
Information Evidence Level Patients/Characteristics (E:C) (Mean:SD: N)
Author: Methodology: N: Group 1: Mortality: Mean decrease in TSB (24 hours):
Tan K RCT 52 Double Volume Exchange transfusion Group 1: 0/26 Group 1: -26 ± 24 micromol/litre
Group 2: 0/26
Year: Blinding: Inclusion: Group 2: Group 2: -77 ± 17 micromol/litre
1975 Not reported Non-hemolytic jaundice Phototherapy
Treatment failure (repeated
Country: Randomisation: Exclusion: Both treatments initiated at treatment)
Singapore Not reported Not reported 256.micromol/litre in preterm babies and Group 1: 8/26
at 308 micromol/litre in term babies Group 2: 0/26
197
ID: Evidence level: Demographics:
1 - Gender (M/F): 28/24 Exchange transfusion was performed in TSB < 188 micromol/litre
Mean GA: the morning using the umbilical vein. Group 1: 3/26
37.0 ± 2.78 weeks Acid Citrate Dextrose blood (warmed to Group 2: 25/26
o
37 C) less than 5 days old was used.
Mean BW: 2501 ± 576 gms Volume was 170ml/kg body weight
Age at entry to study Daily TSB values from capillary blood
84 ± 12 hours were determined until stabilisation at a
Mean TSB: safe level or an obviously decreasing trend
297 ± 25 micromol/litre were observed.

Phototherapy consisted of seven
fluorescent lamps
Light spectral range = 400 – 500 nm
Energy output range = 250 –
330 microwatt/cm²
Phototherapy discontinued at TSB
< 188 micromol/litre
Author: Methodology: N: Group 1: Mortality: Mean decrease in TSB:
Amato M RCT 20 Double Volume Exchange Transfusion Group 1: 0/10 Group 1: -73 ± 33 micromol/litre
Group 2: 0/10
Year: Blinding: Inclusion: Group 2: Group 2: -69 ± 20 micromol/litre
1988 Not reported ABO incompatibility, Single Volume Exchange Transfusion
Hyperbilirubinaemia Duration of phototherapy (hours):
Country: Randomisation: Blood preparation Group 1: 38.1 ± 16.4 hours
Switzerland Random numbers Exclusion: A unit of packed red cells was used.
table Perinatal asphyxia, Mean blood volume of each unit was Group 2: 45.4 ± 17.7 hours
196
ID: Congenital anomalies, 280 ± 40 ml (2/3 red cell volume and 1/3
Evidence level: Documented congenital plasma volume) Rebound level:
1 - infection, Mean sodium was Group 1: 74 ± 41 micromol/litre
Suspected or proven bacterial
infection, 168 ± 43 micromol/litre Group 2: 65 ± 17 micromol/litre

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