Polycythemia in a neonate is defined as the occurrence at any time in the first week of life of either:
(1) a venous hematocrit > 65%, OR
(2) a hemoglobin > 22 g/dL
The goal of partial exchange with plasma is to lower the hematocrit to 55-60%.
Procedure: Whole blood is removed. An equal volume of fresh frozen plasma or 5% human albumin is then infused into the patient.
volume to blood to remove and plasma to infuse =
= ((blood volume) * ((observed hemoglobin) - (desired hemoglobin)) / (observed hemoglobin))
where:
• The blood volume of a full-term infant is about 85-87 mL / kg.
• For premature infants, the blood volume is 108 mL / kg.
• The desired hemoglobin may range from 18.7 to 20.4 g/dL (these correspond to 55 to 60 percent hematocrit, respectively).
