The blood to be transfused should be rhesus negative and compatible with the mother's blood. Other important features are CMV negative, at 37 degrees C.
The volume of blood should be twice that of the infant, ie 180 ml per kg, which will replace about 90% of the infant's cells.
The exchange should take place over two or three hours; the blood is infused usually through a venous line and blood removed at intervals of a few minutes via an arterial line. The amount removed should equal the amount infused. Care should be taken to flush the arterial line after each aliquot of blood is removed to prevent clotting.
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