Which blood product is preferred to control hyperbilirubinemia during exchange transfusion?

The preferred blood product to control hyperbilirubinemia during exchange transfusion is red blood cells suspended in fresh frozen plasma. This choice is advantageous because the fresh frozen plasma contains important components that help to bind and eliminate bilirubin from the circulation, which is especially beneficial in cases involving conditions like hemolytic disease of the newborn.

During exchange transfusion, the goal is to reduce the levels of unconjugated bilirubin in the bloodstream rapidly. Fresh frozen plasma provides both volume expansion and contains proteins which can help in the binding and removal of bilirubin. Additionally, using red blood cells suspended in fresh frozen plasma helps to ensure that the red blood cells are adequately suspended in a plasma environment, which contributes to better circulation and perfusion to tissues.

Using fresh whole blood may introduce additional antigens and also carries the risk of exposing the recipient to other elements that could exacerbate existing conditions. Washed red blood cells, while removing plasma and some potential antigens, do not provide the necessary proteins to help manage bilirubin levels. Heparinized red blood cells could help with clotting issues but don't address the bilirubin concentration directly.

Overall, the preference for red blood cells suspended in fresh frozen plasma in exchange transfusions specifically addresses the complications associated with