Adverse events associated with neonatal exchange transfusion for hyperbilirubinemia.

OBJECTIVE: The main purpose of hyperbillirubin treatment is to prevent high billirubin concentration that may cause Kernicterus. We conducted this study to estimate the incidence of blood exchange and determine causes and complication of blood exchange and identify strategies for risk reduction of Kernicterus in newborn with jaundice. METHODS: From march 2004 to march 2006 in neonatal Department in children hospital, medical center Tehran, Iran, 346 neonates were admitted as neinatal jaundice without sign and symptoms of infections. We identified causes and complications of exchange. data processing and analysis was conducted by SPSS versions 11.5. RESULTS: Of 346 infants with jaundice who received phototherapy. 50, 14.45 percent cases underwent exchange transfusion with mean age 9.38+5.75 days. The mean total Serum billirubin level was 29.39+6.13mg/dl. ABO incompatibility was the most common cause for hyperbillirubinemia.the incidence of apnea was 12% there was no direct death frmo exchange transfusion. CONCLUSION: To make payment women aware to cbserve jaundice regularly after birth of their child and short breast feeding to control dehydretion.

Evaluation of efficacy, survival rate and complications of peritoneal catheter placement of patients with end-stage renal disease

Peritoneal dialysis [PD] as an equivalent to hemodialysis [HD] is one renal replacement therapy [RRT], which has several advantages compared to hemodialysis. However, most nephrologists are reluctant to apply this method. The purpose of this study is to assess the catheter efficiency, survival rate and complications of PD catheter placement in end-stage renal disease [ESRD] patients. From September 2002 to September 2003, 21 patients were operated by PD catheter placement in Imam Hossein Hospital, Tehran, Iran. The kind of catheter and surgical technique were identical in all patients. After surgery, patients were observed for 6 months. Out of the 21 patients, 13 [61%] were males and 8 [39%] were females. Diabetes and hypertension were the most common cause of nephropathy, mean age was 51.2 years and mean time between operation and from the beginning of PD was 9 days [range 1-14 days]. In 8 [38%] patients, the 2 weeks break-in period was ignored. Complications observed were as follows: peritonitis in 2 [9.5%], leak of dialysate in 2 [9.5%], abdominal wall hernia in 2 [9.5%], catheter malfunction in 2 [9.5%] and abdominal wall hematoma in 2 cases [9.5%]. The catheter lasted 6 months in all cases. However, 12 patients who previously received hemodialysis were more satisfied with PD. From the point of prevalence, our complications were not significantly different from previous studies. The 6-month survival rate and efficiency of catheter was very high. In addition, the rate of satisfaction of patients who received PD was also high. We suggest that more accurate studies on ESRD patients should be carried out to evaluate the use of PD in the primary stage of ESRD instead of HD