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Exchange Transfusion


Presentation

  • Hepatorenal impairment was present and malaria parasites with ring form were seen on malaria prep in 18% of red blood cells.[ncbi.nlm.nih.gov]
  • Acute leukemia has the highest risk of mortality and morbidity at presentation when associated with hyperleukocytosis.[ncbi.nlm.nih.gov]
  • As such, patients with sickle cell disease present unique challenges during heart surgery using cardiopulmonary bypass (CPB).[ncbi.nlm.nih.gov]
  • A 36-year-old Caucasian male presented with adult T-cell leukemia/lymphoma (ATL). HTLV-1 contamination was attributed to a neonatal exchange transfusion. Remission was achieved but 11 years later he presented with symptoms suggesting ATL relapse.[ncbi.nlm.nih.gov]
  • OBJECTIVE: The aim of present study was to evaluate the indications and the complications associated with neonatal exchange transfusion (ET) performed for hyperbilirubinemia.[ncbi.nlm.nih.gov]
Pertussis
  • Exchange transfusion should be considered in patients with severe pertussis with hyperleukocytosis.[ncbi.nlm.nih.gov]
  • The use of exchange blood transfusion early in the course of the disease might help to prevent a fatal outcome of malignant pertussis.[ncbi.nlm.nih.gov]
  • A 3-month-old infant of 33 weeks' gestation was hospitalized with pneumonia caused by Bordetella pertussis.[ncbi.nlm.nih.gov]
Severe Clinical Course
  • Risk factors that may be associated with a more severe clinical course include immunosuppression, splenectomy, and advanced age.[ncbi.nlm.nih.gov]
Scleral Icterus
  • Her physical examination was remarkable for scleral icterus, dry mucous membranes, and tachycardia.[ncbi.nlm.nih.gov]
Focal Neurologic Deficit
  • Four patients had seizures; three had focal neurologic deficits for more than 24 hours. Cerebral arteriography demonstrated vascular abnormalities, including irregularity, stenosis, and complete occlusion of vessels.[ncbi.nlm.nih.gov]
Tonic-Clonic Seizure
  • Shortly after a generalized tonic-clonic seizure he passed several tablets in his stool. Salicylate (ASA) level was 85 mg/dL.[ncbi.nlm.nih.gov]

Workup

  • His laboratory workup revealed a markedly raised direct hyperbilirubinaemia and transaminases with prolonged prothrombin time. His serology was negative for HbsAg, HBc IgM, anti-HCV, HAV IgM, HEV IgM, and IgG.[ncbi.nlm.nih.gov]
Hypertriglyceridemia
  • In cases of profound, symptomatic hypertriglyceridemia due to lipid overdose, double-volume exchange transfusion should be considered, even in extremely preterm infants.[ncbi.nlm.nih.gov]
Bordetella Pertussis
  • A 3-month-old infant of 33 weeks' gestation was hospitalized with pneumonia caused by Bordetella pertussis.[ncbi.nlm.nih.gov]
Babesia Microti
  • A previously healthy, 58-year-old man was infected by Babesia microti, presumably through a tick bite.[ncbi.nlm.nih.gov]

Treatment

  • BACKGROUND: Exchange transfusion (ET) has remained a controversial adjunct therapy for the treatment of severe malaria.[ncbi.nlm.nih.gov]
  • Several treatments have been proposed including intrauterine transfusion, laser surgery, elective delivery and expectant management. The optimal treatment remains unclear.[ncbi.nlm.nih.gov]
  • Liver transplantation is often required, since no effective medical treatment has been found.[ncbi.nlm.nih.gov]
  • A comatose, 14-day-old boy was referred to our emergency department (ED) after an overdose of phenobarbital, which was used for the treatment of long-standing jaundice. Plasma phenobarbital concentration was 112.4 microg/ml before treatment.[ncbi.nlm.nih.gov]
  • RESULTS: Twelve hours after WBE treatment, 26 of 30 (86.7%) patients' Hb levels were elevated immediately.[ncbi.nlm.nih.gov]

Prognosis

  • The etiology was unidentified in 103 patients (16.8%), of whom 62 (60.1%) developed ABE and 9 (8.7%) had a poor prognosis.[ncbi.nlm.nih.gov]
  • Neonatal hemochromatosis is a rare congenital disorder of the liver associated to a poor prognosis. Liver transplantation is often required, since no effective medical treatment has been found.[ncbi.nlm.nih.gov]
  • The first two types are mild, last 4 h, are usually treated at home, have good prognosis with normal sexual function.[ncbi.nlm.nih.gov]
  • Outlook (Prognosis) The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life. Mechanical heart valves do not often fail. However, blood clots can develop on these valves.[mclarenhealthplan.org]

Etiology

  • The etiology was unidentified in 103 patients (16.8%), of whom 62 (60.1%) developed ABE and 9 (8.7%) had a poor prognosis.[ncbi.nlm.nih.gov]
  • In present study, the etiology of hyperbilirubinemia and complications of ECT were studied over a five-year period in the Eastern Mediterranean region of Turkey.[ncbi.nlm.nih.gov]
  • We propose etiologic mechanisms for cerebral injury in TAPS, discuss the rationale behind this treatment alternative, and evaluate the pros and cons of the various management options.[ncbi.nlm.nih.gov]
  • Despite mounting evidence of an alloimmune etiology of this condition, exchange transfusion has never been proposed as a specific treatment for neonatal hemochromatosis. Here we describe two siblings affected by neonatal hemochromatosis.[ncbi.nlm.nih.gov]
  • In order of frequency, unknown etiology (25.4%), Rh incompatibility (16.1%) with no immune hydrops, Sepsis(8.5%), urinary tract infection (5.1%) and others (3.4%) (Including Crigler-Najjar and cephalohematoma) were next ones.[ncbi.nlm.nih.gov]

Epidemiology

  • Commenda 12, 20122 Milan, Italy. andrea.ronchi@mangiagalli.it. 3 Neonatal Intensive Care Unit, Department of Pediatrics and Child Neuropsychiatry, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy. bizzarribianca@gmail.com. 4 Epidemiology[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • The proposed pathophysiology of these neurological events is related to cerebral ischemia after an acute increase in per cent total hemoglobin, concomitant decrease in per cent hemoglobin S and subsequent release of vasoactive substances during penile[ncbi.nlm.nih.gov]

Prevention

  • […] and iron overload prevention.[ncbi.nlm.nih.gov]
  • In terms of HbS decrease, stroke prevention, and iron overload prevention, this method showed comparable efficiency to erythrapheresis.[ncbi.nlm.nih.gov]
  • The target is usually to maintain a hemoglobin S level below 30% to prevent complications occurring.The commonest routine reason is to prevent a stroke occurring or re-occurring.[en.wikipedia.org]
  • In order to prevent adverse effects of ECT, serum bilirubin levels should be closely monitored in newborns with ABO immunization.[ncbi.nlm.nih.gov]
  • BACKGROUND: Many SCD patients receive chronic transfusions for prevention or treatment of disease related complications.[ncbi.nlm.nih.gov]

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