Establishing a mathematical standard model for calculating the volume of peripheral arteriovenous synchronous blood exchange transfusion in neonates with severe hyperbilirubinemia

Abstract

Objective: To study the optimal blood exchange transfusion (BET) capacity in neonates with severe hyperbilirubinemia and establish a mathematical standard model for calculating the volume of BET.

Methods: The clinical data of 30 neonates with severe hyperbilirubinemia who received BET in the NICU of Sixth Affiliated Hospital of Nantong University between January, 2016 to December, 2022 were analyzed retrospectively. All neonates received single-volume exchange transfusion (SVET). Serum bilirubin levels were measured every 15 minutes, and serum calcium, blood glucose, hemoglobin, and platelet levels were monitored every 30 minutes of the procedure. The observation decline curve of bilirubin was plotted, and a standard mathematical model for the arteriovenous synchronous exchange transfusion was established. The standard control curve was then calculated, and the two curves were analyzed and compared. The incidence of adverse events was compared between the first and the second half of BET.

Results: There was a statistically significant difference in hemoglobin levels and platelet counts between different points of the procedure (0, 30, 60, 90, and 120 minutes; F = 12.710, 68.620; P < 0.001). During exchange transfusion, there was a significant decline in bilirubin levels every 30 minutes (F = 5273.00, P < 0.05). The clearance of total serum bilirubin (TSB) in the first half of the BET was higher, and the incidence rate of major adverse events was significantly lower than in the second half (P < 0.05).

Conclusions: SVET can effectively reduce total serum bilirubin levels in neonates with severe hyperbilirubinemia. Clinicians may use SVET for treating the condition in combination with phototherapy.