Plasmapheresis in newborns with hyperbilirubinemia.

With a miniaturized plasmapheresis system consisting of a double head pump and balancing pump, extracorporeal detoxification treatments such as plasmapheresis, hemofiltration, and hemodialysis were carried out. In total 15 premature infants and newborns with Rherythroblastosis and hyperbilirubinemia were treated using this miniaturized system. The average birth weight of the 15 patients was 2,386 g. With a main blood flow of 5.3 ml/min and a filtrate flow of 1.3 ml/min, an average of 192.4 ml of plasma per treatment was exchanged. In all patients 1 to 10 plasmapheresis treatments were necessary to reduce the mean serum bilirubin from 15.6 +/- 4.8 to 7.3 +/- 3.2 mg/dl, and after several days the serum bilirubin subsequently normalized in 12 patients, who improved. Three patients died 5 to 18 days after birth as a result of their primary disease and immaturity. For vascular access small catheters were inserted in the umbilical or the femoral vein. All treatments were well tolerated by the patients.