To determine the role of intravenous administration of human albumin prior to blood exchange in term neonates for reduction of total serum bilirubin (TSB).
Randomized controlled trial.
Neonatal Unit of Nemazee Hospital, affiliated with Shiraz University of Medical Sciences, southern Iran.
Fifty out-born term neonates with gestation age >37 weeks, birth weight >2500 g, otherwise healthy with TSB ≥25 mg/dL requiring blood exchange due to intensive phototherapy failure.
Intervention group (n=25) received intravenous human albumin 20% (1 g/kg) one hour before exchange while the control group (n=25) underwent a blood exchange.
TSB level at 6 and 12 hours postexchange, total duration of phototherapy, need for a second exchange transfusion and adverse effects.
The mean TSB level in albumin-treated group was significantly lower than that in the control group at 6 and 12 hours post-exchange (P<0.001). Mean duration of phototherapy was significantly reduced in the albumin-treated group, compared to that in the control group (8.6±2.4 vs. 25±8.2 hours) (P<0.001). None of the neonates in albumin-treated group needed exchange transfusion again and no side effects were observed.
Infusion of 20% albumin (1 g/kg) one hour prior to blood exchange can significantly reduce the postexchange total serum bilirubin and duration of phototherapy.