The evaluation of polycythemic newborns: efficacy of partial exchange transfusion

Objectives. 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.