Exchange transfusion will give an urgent reduction in the serum levels of bilirubin, especially where the hyperbilirubinaemia is the result of rhesus isoimmunisation.
For treatment threshold graphs for phototherapy and exchange transfusion for babies with gestational ages from 23 weeks to 38 weeks or more
Consensus-based bilirubin thresholds for management of babies 38 weeks or more gestational age with hyperbilirubinaemia
Table: An exchange transfusion should be performed unless the bilirubin level falls below threshold while the treatment is being prepared
Age (hours) | Bilirubin measurement (micromol/litre) |
0 | > 100 |
6 | > 150 |
12 | > 200 |
18 | > 250 |
24 | > 300 |
30 | > 350 |
36 | > 400 |
42 | > 450 |
48 | > 450 |
54 | > 450 |
60 | > 450 |
66 | > 450 |
72 | > 450 |
78 | > 450 |
84 | > 450 |
90 | > 450 |
96+ | > 450 |
Reference:
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