Abstract
The circulatory effects of hemodilution (HD) in neonatal polycythemia (POLY) are unknown. Doppler ultrasound measures of flow velocity integrals (FI) from pulmonary artery (PA) and ascending aorta (Ao) correlate directly with PA and Ao stroke volume, while PA acceleration time (AT) correlates inversely with PA pressure and resistance. We evaluated the sequential changes in these indices in POLY neonates (x Hct 69%) and a matched group of normal (NORM) neonates (x Hct 57%) at 5, 7, 24 and 48 hrs of age. The POLY group underwent exchange transfusion between 5 and 7 hrs to lower x Hct to 51%*, The results follow:
There was no difference between the 2 groups compared at each of the 4 time periods suggesting that POLY had no central hemodynamic effect. PA FI and PA AT gradually increased from 5 to 48 hrs in both groups suggesting a decrease in left to right ductal shunt and a fall in PA pressure and resistance. While there was a slightly greater rate of increase in PA FI and PA AT between 5 and 7 hrs (following HD) in POLY compared to NORM, HD provided little overall central hemodynamic benefit.
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Waffarn, F., Takenaka, K., Dabestani, A. et al. 1555 THE EFFECTS OF HEMODILUTION ON THE PULMONARY AND SYSTEMIC CIRCULATIONS IN NEONATAL POLYCYTHEMIA. Pediatr Res 19, 370 (1985). https://doi.org/10.1203/00006450-198504000-01579
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DOI: https://doi.org/10.1203/00006450-198504000-01579