Technique for automated exchange transfusion in pediatric patients with sickle cell crisis
Díaz-Sotomayor, F.; Fernández-Seín, A.; Gonzalez, A.; Gotay, F.
Boletin de la Asociacion Medica de Puerto Rico 95(1): 36-38
2003
ISSN/ISBN: 0004-4849 PMID: 12898749 Document Number: 10011
The automated exchange transfusion technique is currently used at our institution for exchange transfusion of patients with sickle cell crisis (i.e. acute chest syndrome). The simultaneous withdrawal and replacement of blood is achieved using two infusion pumps, one aspirating the patient's blood and the other replacing equal volumes of donor blood at exactly the same rate by either an hemodyalisis catheter or two vascular accesses. The previously used technique was the conventional two catheter technique with one person withdrawing the patient's blood from an arterial catheter trying to match the donor blood being infused by a pump connected to a venous catheter. The automated exchange transfusion technique is an alternative when exchange transfusion is indicated and the aphaeresis technique is not available or the patient's weight is less than 20 kg., since the lines and filters of the apheresis machine that we have available is not suited for that patient population. The efficacy of this technique has been evidenced in patients with sickle cell crisis by a good clinical response as well as by a reduction in up to 50% of Hgb S. There are several other advantages of using the new method including: reduction of hemodynamic disturbances, less risk of contamination/infection, less time consuming, more cost-effective, and less health care personnel exposure. In general, this completely automated technique is more efficient and simple than the ones used at our institution in the past.
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