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The Use of Heparinized Blood for Exchange Transfusion in Infants

HERSCHEL P. BENTLEY Jr., M.D.; NEWELL R. ZIEGLER, M.D., Ph.D.; WILLIAM KRIVIT, M.D., Ph.D.
AMA Am J Dis Child. 1960;99(1):8-17. doi:10.1001/archpedi.1960.02070030010003.
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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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