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July 1982

Morbidity due to Exchange Transfusion With Heat-Hemolyzed Blood

Author Affiliations

Wake County Medical Center Raleigh, NC and University of North Carolina Chapel Hill

Am J Dis Child. 1982;136(7):646-648. doi:10.1001/archpedi.1982.03970430078026

Although mortality due to neonatal exchange transfusion is reported to be less than 1%,1 morbidity is not well known. Many of the immediate complications are deemed iatrogenic and are thought to be diminished if the procedure is performed by an experienced operator.2 This case report relates the morbidity of severe hyperbilirubinemia to malfunction of a blood warmer used in exchange transfusion.

Report of a Case.—A 2,750-g male infant was born to a 26-year-old, gravida 2, para 2, O-positive mother. Maternal medical history was unremarkable and the pregnancy was benign until spontaneous rupture of membranes at 36 weeks' gestation. Labor was uneventful and vaginal delivery produced a male infant with one- and five-minute Apgar scores of 9 and 9.

The infant experienced respiratory distress, his oxygen requirement increasing to 100% over 24 hours. At 36 hours of age, he was intubated and given assistance with a respirator. Chest

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