THE ACID‐BASE AND ELECTROLYTE PATTERN IN THE ERYTHROBLASTOTIC INFANT AND ITS RELATIONSHIP TO VARIOUS PARAMETERS DURING EXCHANGE TRANSFUSION

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Abstract
Summary: The effect of exchange transfusion in the electrolyte and acid‐base balance has been studied in 37 newborn infants undergoing the procedure because of hyperbilirubinemia. Particular interest was focused on possible relationships between induced changes and various pertinent parameters such as infant and donor blood characteristics and rate and volume of the exchange. A statistically highly significant decrease in pH and plasma bicarbonate was noted together with a decrease of the potassium level. Changes in other electrolytes were inconsistent. There was a highly significant correlation between rate of exchange and acid‐base disturbance as well as between induced potassium decrease and the total volume of the procedure. There was no demonstrable increase of the susceptibility to induced changes among the low‐weight infants. A recovery period of 20 minutes was usually sufficient to allow for the control of the metabolic derangement and in some instances an alkalotic overshoot was encountered as related to the preoperative control value. The potassium level continued to fall during the recovery period.The technical aspects of the procedure are discussed against the reported findings.