Volume : IX, Issue : II, February - 2020

A STUDY ON EFFICACY OF PARTIAL EXCHANGE TRANSFUSION WITH NORMAL SALINE IN NEONATAL POLYCYTHEMIA.

Dr Subinay Mandal

Abstract :

BACKGROUND: Neonatal polycythemia is a significant health problem. Partial exchange is the mainstay of treatment. Fresh frozen plasma (FFP) is usually used as replacement fluid but associated with blood product transfusion related complications. Normal saline is inexpensive and devoid of blood product related complications. With this background, this prospective study was undertaken to evaluate the efficacy of normal saline as replacement fluid in PET for treatment of neonatal polycythemia. MATERIAL & METHODS: The proposed study was undertaken in the sick newborn care unit of Department of Pediatrics of Bankura Sammilani Medical College. Partial exchange transfusion was done in symptomatic polycythemic neonates with PV Hct > 65% and in asymptomatic polycythemic with PV Hct. >70%. Normal saline was used as a replacement fluid. Pre & post exchange umbilical venous hematocrit (UV Hct) was also estimated. After completing the PET, the neonates were followed up to note the improvement the clinical signs and symptoms, blood biochemistry and venous hematocrit. Peripheral venous hematocrit was repeated 12 hours & 24 hours after PET. RESULTS: Out of total fourteen polycythemic neonates of our study, eleven were symptomatic and three were asymptomatic. Average age for estimation of venous hematocrit was 7.1 hrs (+1.9hrs). Average capillary hct was 81% (+3.3%). Average PV Hct was 71.9% (+3.1%). Average pre exchange UV Hct was 70.3% (+3.4%). Immediate post exchange UV Hct was 56.7% (+1.58%). Average volume of blood that was exchanges was 49.9ml (+1.8ml). During the first follow up at around twelve hours after PET the average PV Hct were 57.9%(+4.3%) which were less than Polycythemic level (<65%). There was also symptomatic improvement. Plethora & peripheral cyanosis disappeared in all the neonates except one. By 24 hrs from the time of PET, all the neonates became asymptomatic except two neonates. No complications were noted that could be due to PET. CONCLUSION: Early PET is effective in reducing raised hematocrit & avoiding life threatening complications. Normal saline is a cheap, readily available, safe and effective replacement fluid for PET.

Keywords :

Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

A STUDY ON EFFICACY OF PARTIAL EXCHANGE TRANSFUSION WITH NORMAL SALINE IN NEONATAL POLYCYTHEMIA., Dr Subinay Mandal INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-2 | February-2020

Number of Downloads : 166

References :