Hemodynamic consequences of neonatal polycythemia

doi:10.1016/S0022-3476(87)80515-2

The Journal of Pediatrics

Volume 110, Issue 3, March 1987, Pages 443-447

https://doi.org/10.1016/S0022-3476(87)80515-2 Get rights and content

The hemodynamic consequences of neonatal polycythemic hyperviscosity and the effects of partial exchange transfusion were evaluated in 13 infants. Mean (±SD) venous hematocrit was 72%±2.5%. After partial exchange transfusion, whole blood viscosity at a shear rate of 11.5 sec⁻¹ decreased from 16.2 to 8.4 centipoise. There were significant (P<0.05) increases in heart rate (127±7.5 to 139±7.8 beats/min), Doppler-derived cardiac index (200±35 to 263±48 ml/kg/min), lef ventricular stroke volume index (1.56±0.23 to 1.89±0.33 ml/kg), systemic oxygen transport (51.4±8.4 to 57.9±11.9 ml/kg/min), and laser-Doppler peripheral (cutaneous) blood flow (+80%) after partial exchange transfusion. The increase in cardiac index probably resulted from reductions in pulmonary and systemic vascular resistance index, the latter decreasing from 0.26 to 0.49 mm Hg/ml/min/kg⁻¹. The greater increase in cutaneous blood flow (+80%) versus cardiac index (+32%) after exchange transfusion suggests hemodynamic compromise and a redistribution of blood flow away from organs that use little oxygen during polycythemia. Our data provide a possible basis for the symptoms of neonatal polycythemia, and demonstrate the acute hemodynamic benefits of partial exchange transfusion.

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⁺: Supported in part by Grant GCRC M01-RR00997-09 from the National Institute of Health.

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Hemodynamic consequences of neonatal polycythemia+

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