Full Description
The practice of transfusing blood started at the bedside but over the last few decades blood transfusion has become more and more a laboratory directed discipline. The emphasis on serology and laboratory controlled measures has made blood transfusion safer and more effective, but laboratory and clinical aspects of the discipline have tended to become increasingly separated. As a result of this separation clinical developments in blood transfusion may not have derived full benefit from the knowledge accrued in blood transfusion services. Over the last five years the Red Cross Blood Bank Groningen-Drenthe has organised yearly symposia with a clinical theme in order to bring blood banks and clinicians closer together. Many of the recent major advances in clinical medicine have been based on developments in blood transfusion practice. This is certainly true for paediatric medicine. For instance, in paediatric oncology, including leukemia, cell separator programmes have made available new forms of support. Further, blood component therapy has provided an effective means of control in some of the bleeding disorders of children. Some of these topics are discussed in this symposium dealing with intensive care. Haemolytic disease of the newborn and exchange transfusion are other aspec.ts of intensive care. Our purpose in dealing with them was twofold.
Contents
I. Historical perspectives of Haemolytic Disease of the Newborn.- I. Historical perspectives of Haemolytic Disease of the Newborn.- II. Pathogenetic aspects.- 1. The serological investigation of Haemolytic Disease of the Newborn.- 2. The laboratory investigation of ABO Haemolytic Disease of the Newborn and dangers arising from the transfusion of group O donorblood containing AB bloodgroup substance of animal origin.- 3. Haemolytic Disease: clinical diagnosis.- 4. Discussion.- III. Preventative aspects.- 1. The supply of anti-Rhesus (D) immunoglobulin in the Netherlands.- 2. Anti-Rhesus (D) immunoglobulin: indications, clinical use and effect on incidence of Haemolytic Disease of the Newborn.- 3. Discussion.- IV. Therapeutic aspects.- A. Metabolic aspects.- 1. Haemolytic Disease of the Newborn: an overview of the principles of therapy.- 2. The use of component therapy in the newborn.- 3. Metabolic effects of exchange transfusion.- 4. Exchange transfusion: metabolic aspects and biochemical changes.- 5. Discussion.- B. Practical aspects.- 1. Paediatrics and bloodtransfusion: practical aspects.- 2. Practical aspects of exchange transfusion.- 3. Indications for exchange transfusion and choice of treatment for Haemolytic Disease of the Newborn.- 4. Progress in exchange transfusion techniques.- 5. Practical experience in neonatal exchange transfusion.- 6. Exchange transfusion in the Netherlands: a personal view.- 7. Discussion.- C. Special Techniques.- 1. Use of infusion pumps for paediatric blood transfusion.- 2. Prevention of severe Haemolytic Disease of the Newborn by weekly small-volume plasmapheresis during pregnancy.- 3. Intra-uterine fetal transfusion in severe Rh-iso immunisation.- 4. Development of infants surviving intrauterine transfusion.- 5. Discussion.- D. Risksof transmitting disease.- 1. Cytomegalovirus infections.- 2. Serodiagnosis and control in viral hepatitis.- 3. Discussion.- V. Intensive care of the neonate.- 1. Some aspects of neonatal thrombocytopenia.- 2. Cytapheresis support in childhood oncology.- 3. Platelet transfusion in bone marrow transplantation in children.- 4. Discussion.- VI. Concluding remarks.- VI. Concluding remarks.
