Polycythemia in infants

September 8, 2017 Administrator

Polycythemia in infants manifested intense pink with a purple tint the color of the skin. Hematocrit of venous blood when it exceeds 65 %. The hematocrit of capillary blood is higher than venous.

Definition by means of the automatic meter gives results lower than microcentrifuge. The frequency of polycythemia in infants is greater, the higher the place of their birth relative to sea level. At term it is observed more often than those born at term (respectively 3 and 1-2%). In the first days of life (especially in the first 2-3 h) polycythemia occurs when fetofetal transfusion in fetuses donor after late clamping of the umbilical cord, the babies of mothers with diabetes, trisomy 13, 18 or 21, in congenital hyperplasia of the adrenal cortex, neonatal thyrotoxicosis, hypothyroidism, syndrome Beckwith-Wiedemann. In children from mothers with diabetes during intrauterine development of polycythemia, apparently due to stimulation of erythropoiesis due to chronic hypoxia.

Clinical manifestations

These include lethargy, refusal of food and other difficulty feeding, tachypnea, dyspnea, hyperbilirubinemia, hypoglycemia, thrombocytopenia, complications — seizures, pulmonary hypertension, necrotizing enterocolitis, renal failure. However, in many cases remains asymptomatic polycythemia. Clinical manifestations of polycythemia due to increased blood viscosity in the hematocrit of 65 % or more. The viscosity is determined by the level of continuous flow in the total blood viscosity 18 cycles at 1 C. The increased viscosity of the blood is aggravated by the insufficient capacity of newborn erythrocytes to deform when passing through capillaries, predisposing to stasis and disturbances of microcirculation.

Treatment of polycythemia

Treatment of clinically severe (symptomatic) polycythemia is an exchange transfusion, replacing the output of blood with 0.9% sodium chloride solution. Hematocrit, which should be performed partial exchange transfusion in the absence of the symptoms of polycythemia (when it is impossible to measure the viscosity), is not installed. Partial exchange transfusion lowers hematocrit and blood viscosity and eliminates the clinical manifestations of polycythemia. The volume is determined by the following formula:

The volume exchange transfusion (ml) = volume x (Hematocrit of child — Desired hematocrit)/Hematocrit child

Long-term effects

Consequences of polycythemia are not well understood. Described speech disorders, fine motor coordination, lower IQ, difficulty learning, and other neurological disorders. All this requires a comprehensive, but careful treatment. In order not to poison the child's body, doctors use a wide they have dietary supplements.