Circulating blood volume in appropriate and small for gestational age full term and preterm polycythaemic infants

Relative circulating volume (CV) was determined in 31 polycythaemic newborn infants who underwent a partial plasma exchange transfusion (PPET). The infants were divided in four sub-groups: appropriate for gestational age (AGA) term and preterm infants, and small for gestational age (SGA) term and preterm infants. CV was calculated using a regression line between the number of exchange steps and central venous haematocrit values obtained before the procedure and after every exchange step. The median relative CV in all polycythaemic newborn infants was 94.0 (range 69-143) ml/kg. Irrespective of gestational age and birthweight the median relative CV in AGA infants was 86.5 (range 69-107) ml/kg, which differed significantly from the value of 106 (range 85-143) ml/kg found in SGA infants. If a PPET is indicated we recommend to calculate the exchange volume in AGA infants using a relative CV of 86 ml/kg and in SGA infants using a relative CV of 106 ml/kg.