If a neonate has polycythemia, then the cause needs to be determined and the clinical severity determined.
Diagnosis of polycythemia:
(1) A hematocrit in a capillary blood sample > 65%.
(2) Confirmation with testing done on a venous blood sample.
Evaluation of the patient:
(1) Evaluate the neonate for dehydration.
(2) Evaluate the neonate for symptoms related to the polycythemia and hyperviscosity.
Management:
(1) If the neonate is dehydrated, then rehydrate and retest.
(2) If the neonate is symptomatic or if the hematocrit is > 75%, then perform a partial exchange transfusion (see Chapter 05).
(3) If the neonate is asymptomatic and the hematocrit is <= 75% then consider hydration, monitor for symptoms and treat any reversible causes.
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Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
