Department of Pediatrics, Medical College, Kolkata, 88, College Street, Kolkata-700 073, India.
J Trop Pediatr. 2011 Jun;57(3):217-21. doi: 10.1093/tropej/fmq083. Epub 2010 Sep 7.
To evaluate the role of 5% albumin infusion before exchange transfusion in reducing post-exchange unconjugated serum bilirubin (UCB) levels in low birth weight (LBW) neonates with intensive phototherapy failure.
In a placebo-controlled Randomized Controlled Trial, 42 healthy LBW (birth weight between 1000 and 2499 g and gestational age ≥ 32 weeks) neonates were randomly allocated into intervention and control groups. Post-exchange UCB at 6 and 12 h were compared in the two groups along with the duration of post-exchange phototherapy, repeat-exchange requirement, adverse effects of albumin and hospital stay.
The intervention group (n = 21) with mean birth weight 1619 ± 324 g, gestational age 34.5 ± 1.65 weeks, peak UCB 19 ± 3.85 mg dl(-1), was demographically comparable with the control group (n = 21) (1660 ± 320 g, 34 ± 1.6 weeks, 19.4 ± 3.59 mg dl(-1), respectively). Significant reduction in the post-exchange UCB (10.55 ± 1.53 mg dl(-1) at 6 h; 5.86 ± 1.21 mg dl(-1) at 12 h in albumin group; 15.26 ± 1.78 mg dl(-1) at 6 h; 11.69 ± 1.52 mg dl(-1) at 12 h in control group) and phototherapy duration (23.8 ± 3.2 h vs. 40.3 ± 7.2 h) was observed in the intervention group (p < 0.0001). Repeat exchange requirement was reduced by 86% (RR = 0.14; 95%CI: 0.19-1.06). Mean duration of hospital stay was significantly lower (10.1 ± 5.8 days vs. 12.4 ± 6.6 days) (p = 0.021). No albumin transfusion-related complications were observed.
评估在换血前输注 5%白蛋白对伴有强化光疗失败的低体重（LBW）新生儿降低换血后未结合血清胆红素（UCB）水平的作用。
在一项安慰剂对照的随机对照试验中，将 42 名健康的 LBW（出生体重 1000 至 2499 克，胎龄≥32 周）新生儿随机分为干预组和对照组。比较两组换血后 6 小时和 12 小时 UCB，以及换血后光疗时间、重复换血要求、白蛋白的不良反应和住院时间。
干预组（n = 21）平均出生体重 1619 ± 324 克，胎龄 34.5 ± 1.65 周，峰值 UCB 19 ± 3.85mg/dl（-1），与对照组（n = 21）（1660 ± 320 克，34 ± 1.6 周，19.4 ± 3.59mg/dl（-1））在人口统计学上无差异。干预组换血后 UCB 显著降低（换血后 6 小时 10.55 ± 1.53mg/dl（-1）；换血后 12 小时 5.86 ± 1.21mg/dl（-1）），光疗时间缩短（23.8 ± 3.2 小时 vs. 40.3 ± 7.2 小时）（p < 0.0001）。重复换血的需求降低了 86%（RR = 0.14；95%CI：0.19-1.06）。平均住院时间明显缩短（10.1 ± 5.8 天 vs. 12.4 ± 6.6 天）（p = 0.021）。未观察到白蛋白输注相关并发症。
