Neonatal jaundice is a common problem among infants immediately after birth. It is the result of the inability of the neonatal liver to clear bilirubin, a breakdown product of blood cells, from the blood. Neonatal jaundice is usually a self-limiting, mild disorder. The most commonly used treatment is fluorescent light exposure, in which the infant is placed under a lamp for a few hours each day. The blue light breaks down bilirubin into a form the infant liver can process and eliminate.

The infant is laid on his or her back, usually under a radiant warmer. The umbilical vein is catheterized with a fluid-filled catheter. The catheter is connected to an exchange transfusion set, incorporating lines to and from a waste container and a pack of donor blood. These are connected by means of a four-way stopcock, to which is also attached the syringe used to remove and replenish the infant's blood. The exchange transfusion now goes ahead in cycles, each of a few minutes duration. Slowly the infant's blood is withdrawn, and the fresh, pre-warmed blood or plasma is injected. After the exchange transfusion, an umbilical catheter may be left in place in case the procedure needs to be repeated within a few hours.

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Exchange transfusion - 2

Review Date: 04/17/2011
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)