Fully automated simultaneous umbilical arteriovenous exchange transfusion in term and late preterm infants with neonatal hyperbilirubinemia

The purpose of this study was to compare the efficacy and safety of two different catheterization techniques of exchange transfusion (ET) used in the therapy of newborn jaundice: fully automated two-way ET technique and the classical one-way ET.The study included babies at gestational age of34 weeks. In total, 107 ETs were performed on 86 babies. Totally, the umbilical vein (UV) group included 54 babies having undergone 69 ETs and the UV/UA group included 32 babies having undergone 38 ETs.The declines in bilirubin levels right after ET (p = 0.018) and 8 h after ET (p = 0.014) were higher in the fully automated UV/UA technique than in the classical UV technique. Furthermore, the duration of intensive phototherapy following ET was shorter in the UV/UA method than in the UV method (p = 0.003). There was no difference between the two methods in terms of ET-associated complications (p = 0.927).In neonatal hyperbilirubinemia, ET with fully automated UV/UA technique is more efficient than the classical ET technique, causing no additional side-effects. It is also more physiological than the classical technique, since it minimizes the fluctuations in the blood volume and intravascular pressure during ET.