All issues > Volume 32(3); 1989

Original Article

J Korean Pediatr Soc. 1989;32(3):311-320. Published online March 31, 1989.

Acid-Base and Electrolyte Change Before and After Exchange Transfusion with ACD-B Blood in Hyperbilirubinemia of Newborn.

Ki Hong Park¹, Chong Woo Bae¹, Yong Mook Choi¹, Chang Ill Ahn¹, Jung Kook Lee²

¹Department of Pediatrics, Kyung Hee University, School of Medicine, Seoul, Korea
²Department of Clinical Pathology, Kyung Hee University, School of Medicine, Seoul, Korea

Received: September 9, 1988;  Accepted: September 9, 1988.

Abstract

Exchange transfusion is being used widely to correct anemia and control existing hyperbilirubinemia for the prevention of kernicterus in newborn. But the blood used for exchange transfusion is stored blood containing anticoagulants and other substances. So many metabolic changes can be developed after exchange transfusion. This study was undertaken to evaluate the acid-base and electrolyte change after exchange transfusion using the ACD-B blood. In 20 patients among the total 28 patients of severe hyperbilirubinemia was undertaken the exchange transfusion at K.H. U.H. during 1 year period from May 1986 to April 1987, we measured the blood levels of Ca, P, Mg, K, Glucose and blood gas analysis before and after exchange transfusion and analysed the results; 1) Blood gas analysis: There was significant decrease in pH after exchange transfusion, but not in PO₂, PCO₂, HCO₃ and BE. 2) Blood glucose: There was significant increase after exchange transfusion and significant decrease 48 hours after exchange transfusion. 3) Calcium: There was significant increase just after exchange transfusion, but not significant decrease 48 hours after exchange transfusion: 4) Magnesium: There was significant decrease just after exchange transfusion. 5) Potassium and Phosphorus: There were no significant changes. Summarizing the above results, the supplementation of NaHCO₃ or THAM for the correction of decreased pH was not required because it’s range of pH fluctuation was not significant. Even though the glucose level was decreased significantly 48 hours after exchange transfusion, the hypoglycemic symptoms was not observed because 5%-Dextrose in water had been supplied to all patients throughout exchange transfusion. Calcium supplementation during exchange transfusion was not needed because there was significant increase in total calcium and no hypocalcemic tetany after exchange transfusion without calcium injection. Magnesium level was decreased significantly just after exchange transfusion but it’s level was within normal Iimit. There was no problems of hyperkalemia. In conclusion, no significant major problems of metabolic alteration such as acidosis, hypogIycemia, hypocalcemia, hypomagnesemia and hyperkalemia were observed during and after exchange transfusion when uring in ACD-B blood stored less than 3 days.

Keywords :ACD-B blood, Metabolic change, Exchange transfusion, Hyperbilirubinemia of Newborn