Double Volume Exchange Transfusion Clinical Pathway, ICU – Cohort
Cohort
Definition of DVET
- Procedure that introduces donor blood (reconstituted blood from the blood bank) in exchange for approximately 85% of an infant’s circulating blood
- The infant’s blood is repeatedly withdrawn in small amounts and replaced with equal amounts of donor blood over approximately 1½–2 hr timeframe
- Purpose is to wash out toxins such as bilirubin or ammonia, and can be used to correct severe electrolyte abnormalities
- Procedure only performed in the ICU setting
Clinical Indications
- Hyperbilirubinemia
- High ammonia
- Severe electrolyte abnormalities
- Acute bilirubin encephalopathy
- Antibody mediated diseases
- Hemolytic disease of the newborn (Rh disease or other)
- Neonatal hemochromatosis: gestational alloimmune liver disease (GALD), consult GI
- Hyperleukocytosis for infants too small for leukapheresis
Exclusions
- Requiring apheresis outside of an ICU
- Requiring single or partial volume exchange