Question
Do newborns with jaundice need a blood exchange?
Answer
The risk of newborn jaundice requiring a blood exchange is generally low. If jaundice appears within 24 hours after birth, and the daily increase in serum bilirubin is greater than 5 mg/dL or greater than 0.5 mg/dL/hour, and persists for a long duration—more than 2 weeks for full-term infants and 4 weeks for preterm infants—without shrinking, even if it continues to deepen or fade within one week to several weeks after birth, it is considered pathological jaundice. Blue light therapy is necessary. Blood exchange can effectively lower bilirubin levels, remove sensitized red blood cells, and reduce anemia. However, blood exchange requires certain conditions and may cause some adverse reactions. Therefore, it should be strictly controlled for indications, which is usually used when phototherapy fails.