The role of exchange transfusion in the management of low-birth-weight infants with and without severe respiratory distress syndrome. I. Initial observations.

Exchange transfusions within the first 8 hours of life, as an adjunct to conventional therapy, were evaluated in two groups of infants: (1) infants with birth weights of less than 1,250 gm without severe respiratory distress and (2) infants of any birth weight with evidence of severe respiratory distress syndrome. A total of 63 infants were studied in Group 1. Infants who received an exchange transfusion had a survival rate of 86% as contrasted with a survival rate of 57% in the control group (p less than 0.01). A total of 82 infants were studied in Group 2. Infants who received an exchange transfusion had a 59% survival rate as compared with a 39% survival rate for the control group (p less than 0.04). The mechanism by which early exchange transfusion improves survival rate is unknown.