Published online May 8, 2016. doi: 10.5409/wjcp.v5.i2.182
Peer-review started: August 16, 2015
First decision: September 17, 2015
Revised: December 15, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: May 8, 2016
Core tip: Exchange transfusion (ET) is effective in preventing bilirubin-induced neurologic dysfunction in infants with severe hyperbilirubinemia. However, the timely initiation of this emergency procedure is frequently constrained by delays at various critical stages from the time the decision to commence ET is made and when ET is actually conducted. These delays must be carefully identified and appropriately addressed in each clinical setting to minimize their adverse impact in the provision of effective ET in low- and middle-income countries. Intensive phototherapy should also be considered a priority during this interval to minimize avoidable ETs.