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Top‐up transfusions in neonates with Rh hemolytic disease in relation to exchange transfusions
Author(s) -
Rath M. E. A.,
SmitsWintjens V. E. H. J.,
Lindenburg I.,
Brand A.,
Oepkes D.,
Walther F. J.,
Lopriore E.
Publication year - 2010
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.2010.01307.x
Subject(s) - interquartile range , medicine , hemolytic disease of the newborn (abo) , exchange transfusion , pediatrics , guideline , retrospective cohort study , anemia , blood transfusion , hemolytic anemia , pregnancy , fetus , pathology , biology , genetics
Objective To study the effect of a restrictive guideline for exchange transfusion (ET) on the number of top‐up transfusions in neonates with Rh hemolytic disease. Study Design Retrospective study of all (near)‐term neonates with Rh hemolytic disease admitted to our center between 2000 and 2008. In December 2005, policy changed from using liberal ET criteria to more restrictive ET criteria. We recorded the number of ETs and the number of top‐up transfusions in the group of neonates before (group I, n = 156) and after (group II, n = 27) the guideline change. Results The percentage of neonates requiring an ET decreased from 66% (103/156) in group I to 26% (7/27) in group II ( P < 0·01). The percentage of neonates receiving a top‐up transfusion increased from 68% (105/154) in group I to 81% (22/27) in group II ( P = 0·25). The median number of top‐up transfusions increased from 1 (interquartile range 0–2) in group I to 2 (interquartile range 1–3) in group II ( P = 0·01). Conclusion In this study, restrictive ET criteria in neonates with Rh hemolytic disease lead to a reduction of the rate of ET but an increase in the number of top‐up transfusions for neonatal anemia.