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  • The infant’s blood is repeatedly withdrawn in small amounts and replaced with equal amounts of donor blood over approximately 1½–2 hr timeframe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