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exchange transfusion

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how u use blood and plasma ..tell me teh details .. we prefer O ve blood for exchange do u use infant blood group

I was not specific enough I guess.

If theres an AB0 incompatibility: we use 0-erytrocytes in AB-plasma, both of the child's Rh-group.

If there's an Rh incompatibilty: we use Rh neg blod of the child's AB0-group.

And; we do not prepare the blood ourselves. Our blood bank/lab prepare the blood, after the have determined and cross-checked bloodgroups of the mother and infant.

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We only use PRBC's to decrease the fluid load. All blood is typed and crossed to baby.

May be you are talking of exchange transfusion of a baby with hydrops fetalis (due to hemolytic process). In which case you may be right in using Packed RBCs to decrease fluid load.

However in case of Exchange transfusion in a setting of hyperbilirubinemia (with no evidence of anemia induced high output cardiac failure), I think using Prepared to order Whole Blood in the blood bank is more physiological and helps to maintain euvolemia. We request PRBCs and Plasma of the required blood groups to be mixed in the Blood Bank and also tell them what Final Hematocrit we desire. Remember most of the people in the blood bank are oriented to adult medicine and require frequent reminders about the is normal hematocrit in newborns.

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We only use PRBC's to decrease the fluid load. All blood is typed and crossed to baby.

I also think that just cross matching the blood with that of the baby's may be hazardous in a setting of hemolytic anemia.

It is essential also to crossmatch it to that of the mother also, to make sure that you will not add to the hemolytic process after you do the exchange transfusion.

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