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Morbidity due to Exchange Transfusion With Heat-Hemolyzed Blood

Am J Dis Child. 1982;136(7):646-648. doi:10.1001/archpedi.1982.03970430078026.
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Although mortality due to neonatal exchange transfusion is reported to be less than 1%,1 morbidity is not well known. Many of the immediate complications are deemed iatrogenic and are thought to be diminished if the procedure is performed by an experienced operator.2 This case report relates the morbidity of severe hyperbilirubinemia to malfunction of a blood warmer used in exchange transfusion.

Report of a Case.—A 2,750-g male infant was born to a 26-year-old, gravida 2, para 2, O-positive mother. Maternal medical history was unremarkable and the pregnancy was benign until spontaneous rupture of membranes at 36 weeks' gestation. Labor was uneventful and vaginal delivery produced a male infant with one- and five-minute Apgar scores of 9 and 9.

The infant experienced respiratory distress, his oxygen requirement increasing to 100% over 24 hours. At 36 hours of age, he was intubated and given assistance with a respirator. Chest


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