Cerebral blood flow velocity in infants with polycythemia and hyperviscosity: Effects of partial exchange transfusion with Plasmanate

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To determine if there are significant changes in cerebral blood flow velocity and vascular resistance in neonates with polycythemia and hyperviscosity, 11 such infants were studied before and after partial exchange transfusion with Plasmanate. Seven matched control infants were also studied. Blood flow velocity of the anterior cerebral artery was measured with a bidirectional continuous waveform Doppler velocimeter. Blood flow and vascular resistance were calculated from the velocity tracings, using the area under the velocity curve and the Pulsatility Index. Reduction in hematocrit and viscosity produced significant increases in blood flow velocity and a reduction in vascular resistance. The postexchange values were similar to those of the control group. These results indicate that infants with polycythemia and hyperviscosity have decreased cerebral blood flow velocity and increased vascular resistance which normalize after partial Plasmanate exchange transfusion.

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    A series of experiments performed between 1980 and 1995 has clarified the changes in brain blood flow, oxygen delivery, and utilization of glucose. Rosenkrantz and Oh used Doppler techniques to demonstrate a reduction of brain blood flow in neonates with polycythemia that returned to normal after partial exchange transfusion (PET).18 To understand the factors responsible for the reduction in brain blood flow they performed further experiments using newborn lambs.

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