Exchange Transfusion


Reviewed by Clinical Practice Committee
April 2012
Clinical Guidelines Back Newborn Services Home Page
Technique   Procedure
Other Related Documents References


1. Two Catheter Push-pull Technique

In Out
Umbilical vein Peripheral artery
or Umbilical vein Umbilical artery 
or Peripheral vein Peripheral artery2
or Peripheral vein Umbilical artery

2. One Catheter Push-pull Technique


N.B: Blood Volume = 70-90 ml/kg for term and 85-110 ml/kg for preterm infants

<1000gms Use 5ml aliquots 
1000-2000gm 10ml
>2000gm 3 15ml



1 Thayyil S, Milligan D. Single versus double volume exchange transfusion in jaundiced newborn infants. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004592. DOI: 10.1002/14651858.CD004592.pub2
2 Chen HN, Lee ML, Tsao LY. Exchange transfusion using peripheral vessels is safe and effective in newborn infants. Pediatrics. 2008 Oct;122(4):e905-10.
3 Iowa_Neonatology_Fellows. Exchange Transfusion. In: Bell EF, Segar JL, editors. Iowa Neonatology Handbook. Iowa City, Iowa:; 2008.
4 Benders MJ, Meinesz JH, Dorrepaal CA, Steendijk P, van Bel F, van de Bor M. Effect of exchange transfusion on brain perfusion and electrocortical brain activity in newborn lambs. Biol Neonate. 1999;75(2):130-6.
5 Robitaille N, Nuyt A-M, Panagopoulos A, Hume HA. Exchange Transfusion in the Infant. In: Hillyer CD, Strauss RG, Luban NLC, editors. Handbook of Pediatric Transfusion Medicine. San Diego, California: Elsevier Academic Press; 2004. p. 159-66.