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January 1960

The Use of Heparinized Blood for Exchange Transfusion in Infants

Author Affiliations

Pediatric Fellow (Dr. Bentley); Associate Professor of Bacteriology and Consultant to Blood Bank at University of Minnesota Hospitals (Dr. Ziegler), and Assistant Professor of Pediatrics, Department of Pediatrics (Dr. Krivit), University of Minnesota.

AMA Am J Dis Child. 1960;99(1):8-17. doi:10.1001/archpedi.1960.02070030010003

The mortality rate and neurological sequelae from hemolytic disease of the newborn have been vastly reduced by the use of the exchange transfusion.1,2 Yet this lifesaving procedure itself is associated with severe complications and can cause death.3-5 Stored citrated blood has been implicated as the cause of many of these untoward reactions. These include convulsions, retching, clinical signs of shock,6 heart block,7 decreased cardiac stroke volume,8 increased venous pressure,3 cardiac irregularities,3 generalized irritability,9 and even death.3-5,9

Many of these deleterious effects of stored citrated blood have been circumvented by use of fresh heparinized whole blood. Previous reports,3,10-12 although limited in number, do indicate the general lack of toxicity of fresh heparinized blood. It is the purpose of this paper to detail the clinical experience in 152 exchange transfusions conducted with heparinized fresh blood. These exchanges were performed at the University

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