Neonatal exchange transfusions in hospitals that provide Level II neonatal care
Is it appropriate to perform a neonatal exchange transfusion in a hospital that provides Level II neonatal care (Click HERE for level of care definitions)? Or should such a procedure be done in a higher level of care facility, such as in a NICU? A colleague at a hospital with a 'Level II nursery' wants to know if other facilities with Level II Nurseries perform neonatal exchange transfusions. The blood bank/transfusion service is able to provide the necessary products, but should these patients be transferred to a more specialized nursery, or treated in a higher level NICU setting.
The following comments have been received.
ADDENDA Nov. 29, 2011
- In response, Rangasamy Ramanathan, MD, Director of the NICU at LAC+USC Medical Center (attribution used with permission) states that Level II NICUs should be able to perform exchange transfusions, provided that the blood bank in the hospital is capable of providing appropriate blood products. Professor Ramanathan notes that all neonatologists are trained to perform neonatal exchange transfusions, and he is aware of other facilities with Level II nurseries performing this procedure. He suggests periodic competency training for the NICU staff.
Submit comments to the e-Network Forum at email@example.com
Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator
W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator
Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator
The e-Network Forum is supported in part by the California Blood Bank Society (CBBS) and the American Red Cross Blood Services (ARCBS) and endorses collegial discussion among blood banking and transfusion medicine professionals. However, neither the CBBS nor the ARCBS in any way endorse the specific views and opinions expressed in the forum. The forum is not intended as a substitute for medical or legal advice and the content should not be relied upon for any medical or legal purposes. Readers should make their own determinations as to: (i) what constitutes appropriate medical, technical, and administrative practices, and (ii) how best to comply with laws and regulations relevant to their questions. For the latter, they should consider consulting, as to any medical matters, a qualified physician, and, as to any legal matters, an attorney familiar with related state and federal laws. The user of the forum, by accessing same, assumes all risks arising out of such use and releases CBBS and their respective members, directors, officers and agents from and against any loss, damage, claim or liability arising out of such use of the Forum.