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December 1960


Am J Dis Child. 1960;100(6):949. doi:10.1001/archpedi.1960.04020040951026

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To the Editor:—I should like to add one serious criticism of the article by Rapmund, Bowman, and Harris on Bilirubinemia in Nonerythroblastotic Premature Infants. As R. L. D. has already mentioned, even a small number of cases of kernicterus in a group whose bilirubin levels rose about 20 mg. % is an unfortunate occurrence, particularly since it is known that kernicterus is an entirely preventable disease. In fact, this latter statement is so well documented now that parents have succeeded in pressing medicolegal suits against physicians who permitted a baby to develop kernicterus. The idea that the hazard of doing exchange transfusion can be greater than that of developing kernicterus has no more merit than the fear of any operation whose danger lies mostly in the lack of skill of the operator. There is no reason why exchange transfusion should have a higher risk than 1% even including sick erythroblastotic

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