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  1. Seems like it is a rarely performed procedure. Would like to get an idea on the prevalence of the procedure where you work. Specifically asking about neonatal, not intrauterine. What kind of hospital (beds)? State? Are infants requiring one usually transferred to hospitals with higher level NICUs?
  2. Was reading in another thread that nurses or doctors were transfusing blood products left out for more than the allowed time, and other minor things that might raise an eyebrow. I was wondering how or even if the lab supervisor was involved in incidences of noncompliance or how these things are found out.
  3. I'm just a student so I've never been outside the lab at a mid-sized hospital. But just wondering how big of an issue is OR compliance, and what exactly are the recurring issues of non-compliance, if there are any? Is there some kind of compliance or QA officer who watches the entire transfusion? How is compliance being measured and monitored?
  4. I saw the above comment from a post several years ago. Does anyone know more about this? Is this an actual concern being taken up by hospitals?
  5. We have a case of severe hyperbilirubinemia secondary to HDFN due to Rh incompatability between mother and a pre-term, moderately underweight (2000g) baby. What are the precise reasons a recon. whole blood is required in neonatal exchange transfusion? Is it still common to wash the red cells? Is there a procedure/SOP anyone can share as to how the recon is made and how the hematocrit is calculated??
  6. American Academy of Pediatrics guidelines on when to initiate phototherapy and neonatal exchange transfusion is based on TSB (Total Serum Bilirubin) measurements (and not TcB (Transcutaneous Bilirubin) measurements.) How many times is a baby, especially a 36 week (premature) baby, allowed to be drawn when monitoring severe hyperbilirubinemia, considering they have only ~180ml blood volume?
  7. How common are neonatal exchange transfusions in general? I'm reading a source that says it is one of the most commonly performed neonatal procedures and others that say that the procedure is so rarely performed that many have never even seen one performed (i'm assuming because the issue is fixed through IUT...correct me if I'm wrong.) 1. Are Neonatal Exchange Transfusions less common than Intrauterine Exchange Transfusion? 2. How common is Neonatal Exchange Transfusion to treat hyperbilirubinemia (as opposed to other conditions)? Would anybody be willing to share a detailed protocol on how a single-volume or double volume neonatal exchange is performed? Thanks.
  8. Thanks for your answer. In the cases of alloimmunized women who lack/forgo prenatal care for their 2nd or future pregnancies, how is it that a O-Pos fetus could survive to near term or term even with critical titers? I understand they're severely jaundiced by this point, but why do some survive and have moderate/severe jaundice and others don't (miscarriage, hydrops, stillbirth)?
  9. Thanks! Let's say there is a slight FMH. Does that FMH eventually heal, preventing the mom's Anti-D from further contact with fetal RBCs? Is that why so many fetuses survive HDFN even if there is Rh incompatibility?
  10. Are there any statistics on the success of pregnancies if a mother HAS been alloimmunized to develop Anti-D? Can pregnancies be successful as long as there is not fetomaternal hemorrhage? What's the likelihood of a mother avoiding fetomaternal hemorrhage in future pregnancies?
  11. What would happen if you did? What's the chance you would get a false positive DAT?
  12. What is the reason there is no incubation step for DAT?
  13. 1. Especially for a neonatal exchange transfusion (for hyperbilirubinemia), isn't there more of a danger of polycythemia if you use PRBC? Am I understanding it correctly?: A specific volume of donor PRBC is being transfused in exchange for the same volume of baby's whole blood. (So the baby's hematocrit is increasing, but the relative plasma volume is being depleted). 2. What is the liquid in PRBC bag? Is it saline? 3. Other than reducing hyperkalemia risk, why do the PRBCs have to be washed for neonatal ET? 4. Why does PRBC prep take ten hours?
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