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Neonatal Partial Exchange for Polycythemia
Neonatal Partial Exchange for Polycythemia
Birth weight
Estimated blood volume
Typical term-neonate blood volume is about 80-90 mL/kg.
mL/kg
Observed hematocrit
%
Desired hematocrit
%
Complete the fields above to see the result.
When to use
- Symptomatic neonatal polycythemia (venous hematocrit typically >65-70%) to lower hyperviscosity while keeping blood volume constant.
Formula
Exchange volume (mL) = blood volume (mL/kg) x weight (kg) x (observed Hct - desired Hct) / observed Hct. Withdrawn blood is replaced mL-for-mL with isotonic crystalloid.
Pearls and pitfalls
- Asymptomatic polycythemia is generally managed with hydration and observation rather than exchange transfusion.