Double Volume Exchange Transfusion Clinical Pathway — ICU
Double Volume Exchange Transfusion Clinical Pathway — ICU
History and Physical
Assess for:
Signs of Bilirubin Encephalopathy
- Early: lethargy, hypotonia, high pitched cry, poor feeding
- Intermediate: irritability, retrocollis, opisthotonos, fever
- Advanced: apnea, stupor, coma
Hyperbilirubinemia Neurotoxicity Risk Factors
- Isoimmune hemolytic disease
- Other hemolytic diseases
- e.g., G6PD Deficiency
- Significant clinical instability in the previous 24 hrs:
- e.g., sepsis, acidosis, asphyxia, significant lethargy, temperature instability
- Albumin
- < 3.0 g/dL GA ≥ 35 wks
- < 2.5 g/dL GA < 35 wks
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