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.



(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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