Transient pulmonary perfusion abnormality after massive exchange transfusion: Case report

Abstract

The principal indications for exchange transfusion are hemolytic diseases of the newborn with hyperbilirubinemia. However, there are some potential complications of exchange transfusion such as infection, coagulopathies (i.e., thrombocytopenia), electrolyte abnormalities (i.e., hypocalcemia), metabolic acidosis, hypoglycemia, and necrotizing enterocolitis. Stored blood develops some platelet-white cell microaggregates. These microaggregates or blood debris have been found to produce changes in pulmonary hemodynamics in animals and have been implicated in post-traumatic pulmonary insufficiency in man. Authors suggested that pulmonary gas exchange alterations following blood transfusion were primarily due to increased dead-space ventilation secondary to vasoconstriction and occlusion of the pulmonary microvasculature because of microaggregates. In this article, a newborn with transient pulmonary perfusion abnormality who had massive exchange transfusion for Rh isoimmunization and hyperbilirubinemia was reported. © 2010 by Türkiye Klinikleri.