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Discussion on the Advisability of Performing Exchange Transfusion in Neonatal Jaundice of Unknown Aetiology 1
Author(s) -
TROLLE DYRE
Publication year - 1959
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1959.tb16066.x
Subject(s) - kernicterus , exchange transfusion , medicine , jaundice , athetosis , pediatrics , etiology , serum bilirubin , bilirubin , intensive care medicine , surgery , disease , chorea
Summary In a study of 1000 newborns jaundice of unknown aetiology was a common finding during the first week of life. In these children the bilirubin values were as follows: ≤10 mg%in 26%of full‐term 62%of premature ≤20 mg%in 6%of full‐term 11%of premature It is known from the the literature that there is a causal relationship between severe jaundice occurring in the first week of life and the subsequent development of athetosis. By carrying out exchange transfusion on children with a serum bilirubin value of ≤20%, and comparing the number with frequency of athetosis reported in the literature, it is shown that the following will be exchange transfused: (a) 2140 full‐term babies in order to prevent subsequent atheticsis in one, but one runs the risk of 21 dying as a result of the procedure itself. (b)92 premature infants to prevent subsequent athetosis in one, but one runs the risk of 4 dying as a result of the procedure. The limit of 20 mg%is thus not appropriate. Through systematic investigations must be found better criteria for exchange transusing new born with jaundice of unknown aetiology. As opposed to this, the criteria for exchange transfusing Rhesus sensitised children are satisfactory. Admittedly it is unnecessary in the case of 44 out of every 100 children but, on the other hand, 56 will be saved from death or kernicterus, with the risk of death due to the procedure in only one case.