PEDIATRICS Vol. 69 No. 4 April 1982, pp. 419-425
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Neonatal Hyperviscosity II. Effect of Partial Plasma Exchange Transfusion

K. Goldberg MS1, F. H. Wirth MD1, W. E. Hathaway MD1, M. A. Guggenheim MD1, J. R. Murphy PhD1, W. R. Braithwaite MD, PhD1, and L. O. Lubchenco MD1

1 Newborn Service, Division of Perinatal Medicine, and Department of Biometrics, University Hospital and School of Medicine, University of Colorado Health Sciences Center, Denver

To determine the effect of partial plasma exchangetransfusion, 20 newborn infants with neonatal hyperviscosity were randomly assigned to observation or treatment with partial plasma exchange transfusion within the first eight hours after birth. They were studied for organ involvement by roentgenogram, blood count, coagulation studies, and neurologic behavior and were followed up using the Brazelton Neonatal Behavior Assessment scale at 8, 24, and 72 hours and 2 weeks of age; in addition, ten control infants without hyperviscosity of similar birth weights and gestational ages were also studied. Exchange transfusion improved blood viscosity but both hyperviscous groups showed a higher proportion of abnormal results than did the control subjects. Infants receiving exchange transfusions subsequently improved during the period from 8 hours to 2 to 3 weeks of age, until they were indistinguishable from the control subjects. Neurologic improvement in hyperviscous infants who had not received exchange transfusions were significantly slower during this period. At 8 months of age, abnormal neurologic and developmental findings were impressive in both groups; no significant differences in neurologic abnormalities were noted at that time. Developmental delays, tremors, spastic diplegia, and monoparesis were found in four of six untreated infants and five of ten infants who had received exchange transfusions. A fine tremor was present in one control child.

Submitted on June 8, 1979
Accepted on July 13, 1981


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