XQ Luo

23 newborns treated with exchange transfusion via the umbilical vein for hyperbilirubinemia were studied retrospectively. Among them, the known causes of hyperbilirubinemia were Rhesus incompatibility (7 cases), ABO incompatibility (9 cases) and glucose-6-phosphate dehydro- genase (3). The level of bilirubin decreased 54% on average after exchange, but in most cases rose again to 83% of the level before exchange after 12 hours. Four cases needed reexchange, all because of Rhesus and ABO incompatibility. One cause of bilirubin level rising again was the remain of anti-red blood cell antibody. For Rhesus incompatibility, the use of Rhesus-positive blood should be considered if Rhesus-negative blood is not available. The level of bilirubin and rate of haemolysis can still be lowered effectively by removing bilirubin and anti-red blood cell antibody via exchange transfusion. The complications of this group during and after exchange were hypothermia, hyponatremia, hypokalemia, hypocalcemia and depression. There was no kernicterus or death after exchange in this group.