The effectiveness of exchange transfusions

Abstract

Exchange transfusions were performed (for non haemolytic hyperbilirubinaemia) on 16 infants with aliquots equal to 10% of the calculated blood volume, and on 12 infants with aliquots equal to 2%. No significant difference in reduction of bilirubin level was found between the two groups. The rate of fall of the HbF levels was demonstrated to be 3.5 times as fast as that of the bilirubin levels, indicating a bilirubin pool probably 3.5 times larger than the plasma volume. A 'two volume' exchange effectively decreased the plasma bilirubin to a safe level at least temporarily. The rebound phenomenon occurred mainly in the first 6 hours after exchange; a rise beyond the pre exchange level at 6 hours indicates a significantly greater chance for a re exchange. From the behaviour of the rebound phenomenon, the theory of a second bilirubin pool is supported.