Partial plasma exchange transfusion improves cerebral hemodynamics in symptomatic neonatal polycythemia

H. S. Bada, S. B. Korones, H. W. Kolni, C. W. Fitch, D. L. Ford, H. L. Magill, G. D. Anderson, S. P. Wong

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Cerebral arterial pulsatile flow changes and the effect of partial plasma exchange transfusion on these pulsatile flow patterns were studied in neonatal polycythemia/hyperviscosity syndrome by transcutaneous Doppler technique. Twenty-two infants with cord blood hematocrit > 58% (> 2 SD above the mean) were studied from a total of 2,400 infants who were screened for cord hematocrit over a 6-month period. Each of 22 infants had the following initial studies: radial artery hematocrit, viscosity, intracranial pressure measurement, and anterior cerebral arterial Doppler study to determine pulsatility index, mean systolic, mean end diastolic and mean flow velocities, and area underneath the curve of the velocity tracings/min. Twelve of 22 infants had radial artery hematocrit < 63%, were normoviscous( < 13.5 cps, 11.25 sec-1) and were designated as control infants. Ten (study infants) were polycythemic (hematocrit ≥ 63%) and hyperviscous (≥ 13.5 cps, 11.25 sec-1). All study patients were treated by partial plasma exchange transfusion. Initial studies were repeated after exchange transfusion. Control infants were not treated. Prior to exchange procedure, the polycythemic hyperviscous infants had significantly higher hematocrit, viscosity and pulsatility index; the other Doppler measurements and heart rate were lower than those of control babies. The exchange procedure resulted in significantly decreased hematocrit, viscosity, and pulsatility index and increase in the other Doppler measurements, heart rate, and intracranial pressure. All postexchange measurements of study infants were not statistically different from the control infants. These data suggest that neonatal polycythemia/hyperviscosity syndrome may be associated with abnormal cerebral hemodynamics that could improve with partial plasma exchange transfusion.

Original languageEnglish
Pages (from-to)157-163
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume291
Issue number3
DOIs
StatePublished - 1986

Bibliographical note

Funding Information:
From the University of Tennessee, Center for the Health Sciences, Department of Pediatrics, Obstetrics, and Gynecology, and Radiology, Memphis, Tennessee, and Memphis State University, Department of Mathematical Sciences, Memphis, Tennessee. Supported in part by March of Dimes Research Foundation Grant No. 6-297. Reprint requests: Henrietta S. Bada, MD, Newborn Center, 853 Jefferson Avenue, Room 301, Memphis, TN 38163.

ASJC Scopus subject areas

  • General Medicine

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