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Clinical and Follow up Study of 52 cases of Blood Exchange Transfusion for Neonatal Hyperbilirubinemia.

Journal of the Korean Pediatric Society 1983;26(10):996-1003.
Published online October 31, 1983.
Clinical and Follow up Study of 52 cases of Blood Exchange Transfusion for Neonatal Hyperbilirubinemia.
Hong In Eum, Jae Gae Rheu, Sang Cheol Lee, Jung Hee Lee
Department of Pediatrics, St. Benedict Hospital Busan, Korea
교환수혈 환아의 임상적 고찰 및 추적 관찰
엄홍인, 류제계, 이상철, 이정희
부산성분도병원 소아과
Abstract
The study was made of 52 cases of neonatal hyperbilirubinemia receiving blood exchange transfusion at St. Benedict Hospital from January 1977 to June 1981 with the following results; 1) 34.6% of total exchanged patients were born at St. Benedict hospital. Remains were born at outside. 2) 27 patients(51.9%) returned for follow up, 21 patients(40.4%) not returned for follow up 4 patients (7.7%) had died. 3) The patients age between P/2 and 2V2 years old had the highest incidence rate as 70.4% on checking D.D.S.T. 4) Of the 27 patients returned, developmental status was studied by D.D.S.T. 21 patients (77.8%) had normal development, 6 patients(22.2%) were retared, 1(3,7%) was questionable. Most of retared patient had cerebral palsy due to kernicterus. 5) Idiopathic etiology was the most common(42.3%), next was ABO-incompatibility(34. 6%) and idiopathic etiology was also leading cause (48.1%) on follow up case. And among the retared cases idiopathic etiology were 3 cases, ABO-incompatibility with prematurity were 2cases, ABO-incompatibility was 1 case. 6) The appearance of jaundice in the most of ABO-incompatibility and idiopathic cases, dated first day of life, and 82.7% of jaundice was noticed within 3rd day of life. 7) The appearance of jaundice in the most of exchanged transfusion cases dated first day of life and all cases of repeated exchange transfusion dated within 3rd day of visible jaundice. 8) The peak age of the time of exchange transfusion was from 4th day to 6th day of life. All 4 cases of delayed exchanged transfusion were retared development. 9) Repeated exchange transfusion rate were higher in idiopathic etiology than in ABO incompatibility. 10) Serum bilirubin level was above the 25 mg% (73%) at time of blood exchange transfusion. Serum bilirubin level was above the 25 mg% in all retared patients. 11) Growth status was normal in follow up cases. 12) Motor disturbance was the prominant finding in all 5 cases of cerebral palsy, speech disturbance was 3 cases, no response to external stimuli was 1 case. All retared cases were born at outside. After exchange transfusion, initially neurologic disturbance was severe, after this there was a tendency toward recovery.
Key Words: Hyperbilirubinemia, Kernicterus, Blood Exchange Transfusion, Growth and Development.


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