Exchange transfusion in haemolytic disease of the newborn.

In a previous study by Anderson, Smith and Walker (1961), it was observed that in four out of 100 infants undergoing exchange transfusion for haemolytic disease of the newborn, a rise of blood pyruvate occurred during the procedure. It was suggested that the rise of blood pyruvate might be due either to the metabolic action of citrate or glucose, and that this biochemical change might be related to the clinical deterioration of some infants during exchange transfusion. Since the previous study was completed, newer enzyme methods for the determination of organic acids have become available. It was decided to make further observations in infants undergoing exchange transfusion to confirm the previous findings and to determine whether the citrate or the dextrose in the acid citrate dextrose (ACD) solution used for preserving the blood was responsible for these changes.