ABSTRACT
Se presenta la tecnica de la exsanguinotransfusion a circuito cerrado y doble metriset en linea, que disminuye las complicaciones atribuibles a cambios cardiocirculatorios al imitar la circulacion neonatal y puede ser efectuado por una persona, permitiendo su sencillez vigilar los otros factores de morbimortalidad del procedimiento, situacion particularmente util en manos poco experimentadas
Subject(s)
Humans , Exchange Transfusion, Whole Blood , KernicterusABSTRACT
Electrocardiographic findings are analyzed out of a total of 80 exanguinotransfusion done in 70 newborns complaining of hyperbilirubinemia due to isoimmunization to Rh factor, to blood group, to subgroup and to liver enzymatic immaturity. Twenty-six of these babies showed subnormal weights. The technique used was especially that of closed circuit with two vessels and continuous droping. Seventeen patients with concomitant respiratory insuficiency were exanguinated. Electrocardiographic disorders were found in 70% with predominance of hypocalcemia --19 cases--and tachycardia in 9 cases. There were no cases of true hyperkalemia, even in the group of patients who were given blood of over three days of extraction. There were 5 cases of hypokalemia; another 5 with overload in right cavities as possible response to hypervolemia. Disorders of rhythm, bradycardia, ischemia lesions and A-V blockage were present as features of poor prognosis in the only two patients who died in one of whom hyperkalemia and in the other one, hypokalemia were identified. Stress is placed on the greater number of disorders present in the group of infants with subnormal weights, as in those affected with added respiratory insufficiencies or with severe hemolytic diseases.
Subject(s)
Exchange Transfusion, Whole Blood/adverse effects , Heart Diseases/etiology , Infant, Premature, Diseases/etiology , Electrocardiography , Female , Gestational Age , Heart Diseases/diagnosis , Humans , Infant Nutrition Disorders , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature, Diseases/diagnosis , MaleABSTRACT
Electrocardiographic and central venous pressure (CVP) records were taken during 30 exchange transfusions practiced to 26 newborns. The technique of two vessels was employed in 26 cases. Operations lasted 84.8 minutes as an average. There was only one death and the transfusion was discontinued in another case because of clinical aggravation and many disorders in the ECG. These disorders reached 40% of the cases with marked predominance of hypocalcemia which appeared as "initial" in three babies with previous history of transfusion. CVP was usually higher than reported for normal newborns and was equal to values found in a similar group of isoimmuned infants. It was high in seven cases, out of which, four complained of severe hemolytic disease and obviously, of anemia. Initial removal of 10 to 20 ml. of blood in these cases, allowed a drop of 3 to 4 cm. of H2O in CVP and its further maintenance at stable levels.
