CRITERIA FOR EXCHANGE TRANSFUSION JAUNDICED NEWBORN

Abstract

Neonatal jaundice is probably the most common medical

diagnosis in the newborn and is frequently found in premature infants. About 80% of preterm infants and 60% of full term infants demonstrate visible jaundice in the first week of life which implies that their plasma bilirubin level exceeds 6 to 7 mg /dL. Amajor contributing factor to the development of

hyperbilirubinemia during the neonatal period is increased bilirubin production, combined with the transitional impairmert of bilirubin elimination processes. Elevated plasma bilirubin concentrations have been associated with brain injury (Kernicterus).

Bilirubin results from the metabolism of hemoglobin present in red blood cells which break down into globin and heme. Globin is aprotein which is broken down into amino acids that are re-used by the body. Heme is oxidized by the enzyme heme oxygenase resulting in iron, carbon monoxide and biliverdin. The iron is re-used and the carbon monoxide is excreted by the lungs.