Abstract
A significant number of sick neonates who undergo exchange transfusion to prevent bilirubin toxicity are also receiving phenobarbital for seizure control. To determine the necessity of phenobarbital reloading after an exchange transfusion, serum phenobarbital concentration was measured during the execution of an exchange transfusion and the total amount of phenobarbital removed was calculated. In three infants of 28, 30, 40 weeks gestational age weighing 1150 gm, 1340 gm and 3130 gm, 3.6 mg, 1.1 mg and 1.4 mg respectively of phenobarbital were removed. The amount removed in these three infants seems related to the preexchange plasma-phenobarbital concentration. Based on these data, the amount of phenobarbital removed by a two volume exchange is negligable. This is in accordance with an estimated volume of distribution of phenobarbital of about 1000 ml/kg in newborn infants. Exchange transfusion for the removal of sensitized red cells is efficient because the distribution volume for red cells is only 80 mg/kg.
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Habersang, R., Rosenfeld, W., Kauffman, R. et al. PHENOBARBITAL REMOVAL BY NEONATAL EXCHANGE TRANSFUSION. Pediatr Res 11, 417 (1977). https://doi.org/10.1203/00006450-197704000-00285
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DOI: https://doi.org/10.1203/00006450-197704000-00285
