Category Archives: Haematology

Tip 1: anaemia

The haemoglobin nadir for term babies is at 8 – 12/52 age. External link: anaemia of prematurity (eMedicine) (updated 2016)

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Tip 216: exchange transfusion 2

Exchange transfusions should always be double-volume (160–200 mL/kg). This removes around 90% of neonatal red cells and 50% of bilirubin. Reference: United Kingdom Blood Services (2013). Guidelines for the Blood Transfusion Services in the United Kingdom. 8th Edition. TSO: Norwich. Previously published: 28/01/15

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Tip 215: exchange transfusion

A bilirubin above the exchange transfusion line should be considered a medical emergency. An exchange transfusion involves removing aliquots of patient blood and replacing with donor blood in order to remove bilirubin and antibodies in isoimmune disease. It takes time to … Continue reading

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Tip 110: polycythaemia 2

Risk factors for polycythaemia include: IUGR Infant of diabetic mother Twin-to-twin transfusion recipient Delayed cord clamping Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill. Previously published: 14/05/14, 01/05/15

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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 … Continue reading

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Tip 106: UAC position

The tip of an umbilical arterial catheter (UAC) should be at: T6 -T11 (high, associated with a lower incidence of vascular complications but no difference in NEC) or L3 – L5 (low). The ductus arteriosus is at T4 – T5. The coeliac axis … Continue reading

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Tip 103: normal coagulation

Values for coagulation parameters are dependant on the gestational and postnatal age. In both preterm and term infants, most haemostatic parameters are at adult values at 6 months of age (i.e. preterm infants have accelerated maturation). Reference: Guideline for the investigation … Continue reading

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