investigation of effects of blood exchange transfusion on selenium in newborn infants by instrumental neutron activation analysis method

The evidence for the effects of blood exchange transfusion on selenium [Se] in newborn infants is unknown. This study was conducted to determine the possible effects of blood exchange transfusion on Se by comparing the Se blood concentrations before and after exchange transfusion in jaundiced neonates. A total of 30 jaundiced term neonates who underwent blood exchange transfusion [EXT] for first time because of idiopathic unconjugated hyperbilirubinemia, were recruited. The Se level of 30 blood bank donors' samples used for EXT were measured and 30 pairs of uncontaminated umbilical cord blood samples were investigated for Se before and after exchange transfusion. The samples were analyzed by instrumental neutron activation analysis method. Serum bilirubin concentrations were measured by venous blood samples before EXT. The average of Se concentration before EXT was higher than that after EXT [629.78 +/- 283.82 SD ppb versus 454.83 +/- 213.75 SD ppb] [P<0.05]. There was significant correlation between the blood concentration of Se before and after EXT and also between the blood level of Se before EXT and total serum bilirubin level [P<0.05]. There was no significant correlation between the blood concentration of Se before EXT and babies' gender and weight [P>0.05]. The average Se level in samples obtained from transfused blood products was 507.90 +/- 223.56 SD ppb. Blood exchange transfusion caused a 28% decrease of the blood Se level because the blood donors had lower blood Se levels than the newborns. Furthermore, there was a significant correlation between the blood level of Se before EXT and the total serum bilirubin level

Acute bilirubin encephalopathy in healthy term neonates requiring exchange transfusion

There is a growing concern about an increasing bilirubin-induced neurological dysfunction [BIND] in healthy term neonates with no evidence of hemolytic disease or other risk factors. This study was done to determine the incidence of BIND in otherwise healthy, breast-fed newborn term infants without hemolysis who underwent exchange transfusion. This study was conducted in jaundiced newborn infants <7 days of age, from April 2005 to April 2007. The infants were selected if they underwent double volume exchange transfusion [ET] in the first week of life. Babies with any condition affecting neurodevelopment were excluded. Data obtained by clinical findings, and predetermined laboratory tests, and questionnaires. Infants with suspected bilirubin associated brain damage were reviewed according to findings. During the 2- year period, 140 term newborn infants underwent ET; 7 of these patients were excluded; 133 patients were followed and 69 patients were selected without BIND, and 64 were assigned to the group with BIND. This study showed that 48% of jaundiced newborn infants who underwent exchange transfusion, manifested bilirubin induced neurological dysfunction. Unsuccessful breast feeding was found to be a statistically significant risk factor for BIND [p:0.001], sex, route of delivery, family history of jaundice, mean maternal age, number of gravity, parity, abortion, and babies mean admission age ,mean age at jaundice presentation, amount of weight loss, mean total serum bilirubin level were not found to significantly influence BIND. Of the healthy term neonates who developed jaundice within the first week of life, 48% without hemolysis who underwent exchange transfusion demonstrated BIND. It is still not clear whether acute bilirubin encephalopathy affects neurodevelopmental outcome or not. Unsuccessful breast feeding was found to be a statistically significant risk factor