title: Restrictive management of neonatal polycythemia.
abstract: Partial exchange transfusion (PET) is traditionally suggested as treatment for neonates diagnosed with polycythemia. Nevertheless, justification of this treatment is controversial. We evaluated the risk for short-term complications associated with a restrictive treatment protocol for neonatal polycythemia. A retrospective cross-sectional analytical study was conducted. Three treatment groups were defined and managed according to their degree of polycythemia, defined by capillary tube filled with venous blood and manually centrifuged hematocrit: group 1, hematocrit 65 to 69% and no special treatment was recommended; group 2, hematocrit 70 to 75% and intravenous fluids were given and feedings were withheld until hematocrit decreased to < 70%; and group 3, hematocrit ≥ 76% or symptomatic neonates and PET was recommended. During the study period, 190 neonates were diagnosed with polycythemia. The overall rate of short-term complications was 15% (28 neonates). Seizures, proven necrotizing enterocolitis, or thrombosis did not occur in any participating neonates. PET was performed in 31 (16%) neonates. The groups did not differ in their rate of early neonatal morbidities or length of hospitalization. Restrictive treatment for neonatal asymptomatic polycythemia is not associated with an increased risk of short-term complications.
authors.affiliation: Department of Neonatology, Mayanei HaYeshua Medical Center, Bnei Brak, Israel. irismorag@gmail.com
authors.forename: Iris
authors.initials: I
authors.lastname: Morag
authors.forename: Tzipora
authors.initials: T
authors.lastname: Strauss
authors.forename: Daniel
authors.initials: D
authors.lastname: Lubin
authors.forename: Irit
authors.initials: I
authors.lastname: Schushan-Eisen
authors.forename: Gili
authors.initials: G
authors.lastname: Kenet
authors.forename: Jacob
authors.initials: J
authors.lastname: Kuint
mesh_terms: D001809:Blood Viscosity; D001810:Blood Volume; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011086:Polycythemia / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012965:Sodium Chloride / Q000627:therapeutic use*; D018709:Statistics, Nonparametric
chemical_list: D012965:Sodium Chloride