Randomized Controlled Trial of Isotonic Saline Versus Albumin in Partial Exchange Transfusion for the Treatment of Neonatal Polysythaemia

Abstract:

Objective To compare the efficacy of isotonic saline and 5% albumin as a replacement fluid in partial exchange transfusion (PET) for the treatment of neonatal polycythaemia. Methods Sixty two neonates with polycythaemia were randomly divided into two groups: PET with isotonic saline group (n=30) and PET with 5% albumin group (n=32). Haematocrit (HC) was measured before and after the treatment. Results HCT significantly declined at 24 h after PET with either saline or 5% albumin compared with that before the treatment [( 0.72 ± 0.04 ) vs. ( 0.56 ± 0.05 )]; [( 0.71 ± 0.03 ) vs. ( 0.55 ± 0.04 ), respectively; P< 0.01 ]. There was no difference between the two groups. Serum sodium, potassium, and total proteins concentrations were not significantly affected by PET in either group. Conclusions Both isotonic saline and 5% albumin are effective as replacement fluids in PET for the treatment of neonatal polycythaemia. Since isotonic saline is cheaper and free of infection, it may be the fluid of choice in PET.