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Neonatal polycythemia and hyperviscosity.
Shikha Sarkar1, Ted S Rosenkrantz
1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
Seminars in Fetal & Neonatal Medicine
|April 22, 2008
Summary
Neonatal polycythemia (high hematocrit) and hyperviscosity can affect organ function. Partial exchange transfusion offers no clear long-term neurodevelopmental benefits and crystalloids are a safe, cost-effective alternative.
Area of Science:
- Neonatalogy
- Pediatric Hematology
Background:
- Neonatal polycythemia (hematocrit >65%) and hyperviscosity can alter organ function.
- While potentially a normal fetal adaptation, it's linked to neonatal abnormalities.
Purpose of the Study:
- To evaluate the efficacy and necessity of partial exchange transfusion (PET) for neonatal polycythemia and hyperviscosity.
- To compare fluid types used in PET.
Main Methods:
- Review of existing data on PET for neonatal polycythemia and hyperviscosity.
- Analysis of studies on neurodevelopmental outcomes.
- Comparison of crystalloid versus colloid use in PET.
Main Results:
- No clear long-term neurodevelopmental benefits demonstrated for PET.
- PET efficacy is questionable in asymptomatic infants and depends on symptoms in symptomatic ones.
- Crystalloids are as effective as colloids for PET, offering cost and safety advantages.
Conclusions:
- Partial exchange transfusion may not be beneficial for all neonates with polycythemia or hyperviscosity.
- Crystalloids are a preferred fluid for PET due to cost-effectiveness and safety.
- Further research may clarify optimal management strategies for neonatal polycythemia.
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