The evaluation of polycythemic newborns: efficacy of partial exchange transfusion.
OBJECTIVE
To evaluate the clinical characteristics and risk factors of symptomatic and asymptomatic polycythemic neonates performed partial exchange transfusion (PET) and to determine the time of resolution of symptoms and effect of PET on short-term morbidity.


METHODS
This prospective cohort study was conducted with symptomatic (hematocrit; Hct>65% plus a clinical symptom) and asymptomatic (Hct level>70% without any symptoms) neonates who underwent PET due to polycythemia.


RESULTS
Among the patients performed PET, 43 (69.3%) were symptomatic and 19 (30.7%) asymptomatic. Persistent pulmonary hypertension and minor problems like hypoglycemia, hypocalcemia, hyperbilirubinemia, and thrombocytopenia improved in all patients within 24 h, 2.5 ± 1.0, 3.1 ± 1.4, 56.2 ± 16.9, and 53.5 ± 10.5 h, respectively, after PET (in except one symptomatic neonate with hypoglycemia). In symptomatic group, in three patients with suspected necrotizing enterocolitis (NEC) prior to PET stage IIa NEC developed. No other clinical and ultrasonographic findings were observed after PET.


CONCLUSIONS
Early morbidities, due to polycythemia may be reversed with PET within a short time. PET did not increase or cause any complications except NEC. The issue that either NEC was a sign of polycythemia or a complication of PET could not be definitely outlined.
Division of Neonatology, Department of Pediatrics, Sisli Etfal Children Hospital, Sisli, Istanbul, Turkey. sinanuslumd@hotmail.com
Sinan
S
Uslu
Hamus
H
Ozdemir
Ali
A
Bulbul
Serdar
S
Comert
Emrah
E
Can
Asiye
A
Nuhoglu
D000328:Adult; D001724:Birth Weight; D002657:Child Development / Q000502:physiology; D015331:Cohort Studies; D005078:Exchange Transfusion, Whole Blood / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D008297:Male; D011086:Polycythemia / Q000151:congenital / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult