Partial Volume Exchange Transfusion, Clinical Pathway, ICU

Pre/intraprocedure Lab Schedule

Order all labs to be drawn during the procedure before starting so that labels can be printed as needed.

Optional labs: discuss if any of these tests should be sent. The results will be affected by the PVET if not sent prior to starting. Note: volumes below are specific to CHOP.

Labs Before and After PVET

Timeframe	Volume Needed	Labs Needed	Optional Labs
Start of exchange	2.5 mL *2 mL without NB screen	CBC BMP Blood gas with ionized calcium Newborn Metabolic Screen if not completed Reticulocyte count If exchange being done for anemia of unclear etiology discuss with hematology studies to send such as hemoglobin electrophoresis and enzyme studies	Genetic/metabolic studies Infectious labs
End of exchange	1.5 mL	CBC BMP Glucose Blood gas with ionized calcium
4 Hours Post Exchange	1 mL	CBC BMP

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

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