pediatrics
Perinatal Polycythemia and Hyperviscosity Syndrome
Treatment
IV hydration Sometimes phlebotomy plus saline replacement (partial exchange transfusion) Asymptomatic infants should be treated with IV hydration (see Treatment ). Symptomatic infants with hematocrit>65 to 70% should undergo an isovolemic hemodilution (sometimes called partial exchange transfusion, although no blood products are given) to reduce the hematocrit to≤55% and thereby decrease blood viscosity. Partial exchange is done by removing blood in aliquots of 5 mL/kg and immediately replacing it with an equal volume of 0.9% saline. Asymptomatic infants whose hematocrit remains persistently>70% despite hydration may also benefit from this procedure. Although many studies show immediate measurable effects of partial exchange, the long-term benefits remain in question. Most studies have failed to document differences in long-term growth or neurodevelopment between children who have received a partial exchange transfusion in the neonatal period and those who have not. 