Effect Of Blood Exchange Transfusion On Serum Electrolytes In Neonates

Background: Blood exchange transfusion is usually practiced when a rapid decline in serum bilirubin is needed in neonates with hyperbilirubinemia. However, this technique is associated with alteration in serum electrolytes of neonates after blood exchange transfusion and these alterations might produce serious problems. Hypocalcemia is common in neonates, it is more common in neonates with birthasphyxia, prematurity, and mother with poor controlled diabetes mellitus, while hypercalcemia in neonates is very uncommon. Sodium ion (Na+) is the main electrolyte in extra cellular fluid (ECF ), while Potassium K+ is the dominant cation in the ICF. These levels are preserved mainly by Na+/K+ ATPase pump which allows K+ entrance in exchange with Na+ . Aim: The aim of this study is to evaluate the effect of blood exchange transfusion on neonatal serum levels of calcium, sodium, and potassium. Method: 36 full term neonates aging 1-15 days who had hyperbilirubinemia that indicated for blood exchange transfusion were enrolled in this study. Serum levels of Ca, Na, and K were measured for those neonates before and after blood exchange transfusion. Results: There was significant increase in serum Ca level (8.48 ± 0.91 versus9.05 ± 0.83) after blood exchange. There was significant increase in serum k level (4.62 ± 1.06 versus 5.16 ± 1.23) after blood exchange. There was nonsignificant increase in serum Na level (146.55 ± 2.47versus 147.22 ± 2.16) after blood exchange Conclusion: blood exchange transfusion is associated with alteration in serum levels of Ca, Na, and K in neonates with hyperbilirubinemia.