Exchange Blood Transfusion Chart Plot bilirubins on appropriate NICE chart Start intensive phototherapy refer neonatal jaundice guideline 2 3 2 Cord blood samples should be taken for SBR DAT and FBC by the midwifery staff and sent off with the knowledge of the neonatal team for urgent assay
Use normal saline for an exchange to lower Hct An exchange is done to raise the HCT when the infant has a chronic anemia with a normal blood volume Use PRBC s to raise Hct An infant s blood volume is 85 ml kg The desired Hct is usually 45 55 Use the following formulas to calculate the amount of the exchange III Exchange transfusion of the neonate is a potentially life saving intervention that involves removing aliquots of blood and replacing with donor blood in order to remove abnormal blood components and circulating toxins whilst maintaining adequate circulating blood volume
Exchange Blood Transfusion Chart
Exchange Blood Transfusion Chart
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Calculate volume of blood to be exchanged double volume exchange removes 90 of baby s red cells and 50 of available intravascular bilirubin Use For anaemia without antibodies or hyperbilirubinaemia use single volume exchange For term Exchange transfusion This LOP is developed to guide clinical practice at the Royal Hospital for Women Individual patient circumstances may mean that practice diverges from this LOP
Always request a haemoglobin S pre and post exchange to gauge efficacy of the exchange transfusion Blood 6 8 cross matched units see how to calculate below of HbS negative blood preferably 1 2 Exchange transfusion may be indicated in significant hyperbilirubinaemia secondary to acute haemolysis by removing the affected red blood cells and circulating maternal antibodies to reduce red cell destruction
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Document on the Exchange Transfusion Record MR460 time of commencement aliquot volumes and total volume exchanged blood specimens observations and time of completion This document is an exchange transfusion record used to track key information for a neonatal exchange transfusion procedure It includes fields to record the patient s name hospital number date of birth total volume of blood exchanged time taken and observations of vital signs taken at least every 30 minutes during the procedure Blood
Exchange transfusion is to be performed withhold enteral feeds Recheck bilirubin at start of phototherapy as baseline Consider the use of 360o phototherapy once IV lines sited Consider Intravenous Immunoglobulin IVIG if any anticipated delay in obtaining blood for exchange transfusion see later section in guideline Monitor ECG blood pressure O2 saturation transcutaneous CO2 and temperature during ExTx
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Plot bilirubins on appropriate NICE chart Start intensive phototherapy refer neonatal jaundice guideline 2 3 2 Cord blood samples should be taken for SBR DAT and FBC by the midwifery staff and sent off with the knowledge of the neonatal team for urgent assay
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Use normal saline for an exchange to lower Hct An exchange is done to raise the HCT when the infant has a chronic anemia with a normal blood volume Use PRBC s to raise Hct An infant s blood volume is 85 ml kg The desired Hct is usually 45 55 Use the following formulas to calculate the amount of the exchange III
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Exchange Blood Transfusion Chart - Exchange transfusion This LOP is developed to guide clinical practice at the Royal Hospital for Women Individual patient circumstances may mean that practice diverges from this LOP
