Exchange transfusion is a therapeutic method for immediate treatment of hyperbillirubinemia to prevent kernicterus, but it has some complications including hypoglycemia and hypocalcemia. This study was performed to find the changes of blood sugar and calcium after blood exchange and their possible correlation with weight, blood incompatibility and bilirubin decrease rate. Thirty-six neonates with blood exchange were evaluated over a period of 6 months. Blood samples were collected from umbilical vein catheter, before and 6 hours after the exchange transfusion, and their total calcium, bilirubin and blood sugar were measured. Following every 100 ml of blood exchange, 1 ml of calcium gluconate (10%) was infused slowly. Our results showed that, 6 hours after exchange transfusion, the total calcium level was decreased. There was no significant correlation between calcium decrement and weight. Also, no significant correlation was found between blood incompatibility and bilirubin decrement. There was no significant alteration of blood sugar 6 hours after exchange transfusion. We recommend using of calcium gluconate during exchange transfusion and serial measurement of calcium level until its level is stable
