Massive fetomaternal haemorrhage warranting novel use of tandem isovolumetric partial exchange transfusion and therapeutic hypothermia.

Autor:	Liggett CJ; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Zven SE; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Schulz EV; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Stark CM; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland, USA chrismylestark@gmail.com.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2023 Dec 30; Vol. 16 (12). Date of Electronic Publication: 2023 Dec 30.
DOI:	10.1136/bcr-2023-256634
Abstrakt:	A newborn male infant was pale, hypotonic, and had respiratory distress after delivery. Venous cord blood gas revealed a severe metabolic acidosis. His initial examination was consistent with moderate encephalopathy and laboratory testing uncovered severe congenital anaemia (haematocrit 0.127 L/L). He met the clinical criteria for therapeutic hypothermia (TH) and required red blood cell transfusions, but due to the severity of his anaemia, an exchange transfusion was favoured to prevent transfusion-associated circulatory overload. There are no previous reports of these procedures completed in tandem, but the benefits were perceived to outweigh the risks. During the 72 hours of TH, the infant received an isovolumetric partial exchange transfusion and tolerated both treatments without any adverse clinical events.Kleihauer-Betke testing detected a massive chronic fetomaternal haemorrhage with 475 mL (164 mL/kg) of blood. A brain MRI completed prior to discharge was normal. At 6 months of age, he is growing and developing normally. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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