Abstract：
OBJECTIVE: To identify indications for exchange transfusions, assess the use and waste of exchange transfusion products (ie, reconstituted whole blood exchange transfusions), and determine nationwide distribution and prevalence of these transfusions in the Netherlands.
METHODS: All 9 neonatal intensive care units and 15 non-neonatal intensive care unit hospitals participated in this retrospective, observational, cohort study. We retrieved data on the indications for and use of all exchange transfusion products ordered by participating centers over an 11-year period.
RESULTS: A total of 574 patients for whom 1265 products were ordered were included for analyses. Severe ABO (32.6%) and non-ABO (25.2%) immune hemolysis and subsequent hyperbilirubinemia were the most frequent indications. Rare indications were severe leukocytosis in Bordetella pertussis (2.1%) and severe anemia (1.5%). Approximately one-half of all ordered products remained unused. In 278 of 574 neonates (48.4%), ≥1 products were not used, of which 229 (82.7%) were due to the resolving of severe hyperbilirubinemia with further intensification of phototherapy. The overall prevalence of neonates who received an exchange transfusion was 14.6:100 000 liveborn neonates.
CONCLUSIONS: A considerable proportion of products remained unused, and annually a limited number of patients are treated with an exchange transfusion in the Netherlands, highlighting the rarity of the procedure in the Netherlands.
METHODS: All 9 neonatal intensive care units and 15 non-neonatal intensive care unit hospitals participated in this retrospective, observational, cohort study. We retrieved data on the indications for and use of all exchange transfusion products ordered by participating centers over an 11-year period.
RESULTS: A total of 574 patients for whom 1265 products were ordered were included for analyses. Severe ABO (32.6%) and non-ABO (25.2%) immune hemolysis and subsequent hyperbilirubinemia were the most frequent indications. Rare indications were severe leukocytosis in Bordetella pertussis (2.1%) and severe anemia (1.5%). Approximately one-half of all ordered products remained unused. In 278 of 574 neonates (48.4%), ≥1 products were not used, of which 229 (82.7%) were due to the resolving of severe hyperbilirubinemia with further intensification of phototherapy. The overall prevalence of neonates who received an exchange transfusion was 14.6:100 000 liveborn neonates.
CONCLUSIONS: A considerable proportion of products remained unused, and annually a limited number of patients are treated with an exchange transfusion in the Netherlands, highlighting the rarity of the procedure in the Netherlands.
摘要：
目的：确定交换输血的适应症，评估交换输血产品的使用和浪费(即，重组全血交换输血)，并确定这些输血在荷兰的全国分布和流行程度。
方法：所有9家新生儿重症监护病房（NICU）和15家非NICU医院都参与了这项回顾性研究，观察,队列研究。我们检索了参与中心在11年期间订购的所有交换输血产品的适应症和使用数据。
结果：共有574名患者订购了1,265种产品，纳入分析。严重的ABO（32.6％）和非ABO（25.2％）免疫性溶血和随后的高胆红素血症是最常见的适应症。罕见的适应症是百日咳博德特氏菌的严重白细胞增多（2.1％）和严重贫血（1.5％）。大约一半的订购产品仍未使用。在574例新生儿中的278例（48.4％），没有使用一个或多个产品，其中229例（82.7％）是由于严重的高胆红素血症的解决以及进一步加强光疗。接受交换输血的新生儿的总体患病率为14.6：100,000活产新生儿。
结论：相当比例的产品未使用，每年在荷兰，有限数量的患者接受交换输血治疗，强调了该程序在荷兰的罕见性。
方法：所有9家新生儿重症监护病房（NICU）和15家非NICU医院都参与了这项回顾性研究，观察,队列研究。我们检索了参与中心在11年期间订购的所有交换输血产品的适应症和使用数据。
结果：共有574名患者订购了1,265种产品，纳入分析。严重的ABO（32.6％）和非ABO（25.2％）免疫性溶血和随后的高胆红素血症是最常见的适应症。罕见的适应症是百日咳博德特氏菌的严重白细胞增多（2.1％）和严重贫血（1.5％）。大约一半的订购产品仍未使用。在574例新生儿中的278例（48.4％），没有使用一个或多个产品，其中229例（82.7％）是由于严重的高胆红素血症的解决以及进一步加强光疗。接受交换输血的新生儿的总体患病率为14.6：100,000活产新生儿。
结论：相当比例的产品未使用，每年在荷兰，有限数量的患者接受交换输血治疗，强调了该程序在荷兰的罕见性。
