Tip 107: polycythaemia

Polycythaemia (a venous haematocrit above 0.65) is relatively common. Most babies are asymptomatic, though a small proportion of babies develop clinical signs related to hyperviscosity, which include:

  • Plethora
  • Jaundice
  • Lethargy
  • Poor suck and feeding
  • Irritability
  • Tachypnoea and tachycardia
  • Hypoglycaemia

A partial exchange is usually indicated if the haematocrit is either more than 0.7 in an asymptomatic infant or more than 0.65 in a symptomatic infant.

Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill.

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