A Comparison of the Effects of Whole Blood and Sedimented Erythrocytes in Exchange Transfusion

Abstract

The relative efficiency of whole blood compared with sedimented erythrocytes in exchange transfusion was studied in regard to the correction of anemia. Two groups of infants with hemolytic disease of the newborn due to maternal-fetal Rh incompatibility were transfused with one or the other type of blood. Determinations of concentration of hemoglobin; packed cell volume; plasma, erythrocyte, and total blood volumes; and total circulating hemoglobin mass were made and compared. It was concluded that the use of sedimented erythrocytes does not lead to a deficit of erythrocyte volume and circulating hemoglobin mass as does the use of whole blood. Analysis of data from 47 infants, 23 of whom received whole blood, and 24 of whom received sedimented erythrocytes, indicates that a significant difference in concentration of bilirubin occurs. The increase in concentration of bilirubin subsequent to exchange transfusion was lower and less rapid in most infants of the group receiving sedimented erythrocytes. For these reasons the use of sedimented rather than whole blood is suggested in exchange transfusion for hemolytic disease of the newborn.