الفهرس 
ِAcknowledgement
HyperbilirubinemiaOnly 14 pages are availabe for public view
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Abstract
Exchange transfusion occupies a unique place in the history of neonatal jaundice because it was the first intervention to permit effective control of severe hyperbilirubinemia and to have the potential to prevent kernicterus. In addition to immediate control of hyperbilirubinemia, an exchange transfusion in immune-mediated hemolytic disease also achieves the removal of antibody-coated red blood cells (a source of “potential” bilirubin), the correction of anemia and the removal of maternal antibody. This audit study was done on 26 patients who were admitted at Neonatal Intensive Care Unit of Assiut University Children Hospital and for whom exchange transfusion was done in one year to evaluate the degree of compliance of management of cases for whom exchange transfusion was done in relation to the guidelines of AAP 2004. Regarding the diagnoses of the studied cases it was found that 73% of the studied cases have ABO incompatibility, where 19.3%hadRH incompatibility and 7.7% had other diagnoses. Coombs test was done in 31% and not done in 69% of the studied cases. Hematocrit and bilirubin level were measured in 100% of the studied cases before and after the exchange. Serum calcium was measured in 38% before and in 19%after exchange of the studied cases. Serum Sodium and Potassium were measured 76% before and in 38% after exchange for the studied cases. All the studied cases were monitored but 89% were monitored properly. The duration of the technique was proper in 77% of the studied cases. The amount of the blood used was proper in 88% of the studied cases. All the studied cases were given medication during exchange transfusion in the form of intravenous calcium gluconate. We concluded that there was no complete compliance to AAP 2004 guidelines and re audit should be done. Recommendations Investigations like serum sodium, potassium, chloride and calcium should be done for all cases before and after exchange transfusion. Coombs test should be done for all cases for work up for diagnosis of neonatal jaundice. Donor blood hematocrit and buffering should be done for all blood bags that used for exchange transfusion this need more cooperation with the blood bank.