THE GASTROINTESTINAL COMPLICATIONS OF NEONATAL UMBILICAL VENOUS EXCHANGE TRANSFUSION: A CLINICAL AND EXPERIMENTAL STUDY

1 January 1973

journal article
Published by American Academy of Pediatrics (AAP) in Pediatrics

Vol. 51 (1) , 36-43
https://doi.org/10.1542/peds.51.1.36

Abstract

Two newborn infants having umbilical venous exchange transfusion for Rh incompatibility developed serious gastrointestinal complications preceded by abdominal distention, bilious vomiting, and blood-streaked meconium stools; 21 other infants with similar findings are reviewed. The clinical material suggests that a vascular mechanism, possibly related to hemodynamic alterations accompanying exchange transfusion may be responsible for the gastrointestinal lesions observed. Significant increase in portal venous pressure (0.8 ± 0.3 to 4.5 ± 0.4 mm Hg) during the injection phase of exchange occurred during experimental exchange transfusion via the umbilical vein of newborn piglets. The authors advise roentgen verification of the umbilical vein catheter within the inferior vena cava prior to undertaking exchange transfusion, eliminating the potential risk of portal venous congestion.

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