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Effect of Albumin Administration Prior to Exchange Transfusion in Term Neonates with Hyperbilirubinemia A Randomized Controlled Trial.

Author(s): Shahian M, Moslehi MA

Affiliation(s): Division of Neonatology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran. Correspondence to: Dr Mozhgan Shahian, Assistant Professor, Division of Neonatology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran. shahianmo@sums.ac.ir.

Publication date & source: 2009-05-20, Indian Pediatr., [Epub ahead of print]

OBJECTIVE: To determine the role of intravenous administration of human albumin prior to blood exchange in term neonates for reduction of total serum bilirubin (TSB). DESIGN: Randomized controlled trial. SETTING: Neonatal Unit of Nemazee Hospital, affiliated with Shiraz University of Medical Sciences, southern Iran. PATIENTS: Fifty out-born term neonates with gestation age > 37 weeks, birth weight > 2500 g, otherwise healthy with TSB > 25 mg/dL requiring blood exchange due to intensive phototherapy failure. INTERVENTION: Intervention group (n=25) received intravenous human albumin 20% (1 g/kg) one hour before exchange while the control group underwent a blood exchange. Outcome Measures: TSB level at 6 and 12 hours postexchange, total duration of phototherapy, need for a second exchange transfusion and adverse effects. RESULTS: The mean TSB level in albumin-treated group was significantly lower than that in the control group at 6 and 12 hours post-exchange (P < 0.001). Mean duration of phototherapy was significantly reduced in the albumintreated group, compared to that in the control group (8.6 +/- 2.4 vs. 25 +/- 8.2 hours) (P <0.001). None of the neonates in albumin-treated group needed exchange transfusion again and no side effects were observed. CONCLUSION: Infusion of 20% albumin (1 g/kg) one hour prior to blood exchange can significantly reduce the postexchange total serum bilirubin and duration of phototherapy.

Page last updated: 2009-10-20

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