Date of Award

January 2011

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Patrick G. Gallagher

Subject Area(s)

Medicine

Abstract

PARTIAL EXCHANGE TRANSFUSION FOR POLYCYTHEMIA HYPERVISCOSITY SYNDROME: A 21-YEAR REVIEW Bridget L. Hopewell, Laurie A. Steiner, Richard A. Ehrenkranz, Matthew J. Bizzarro, and Patrick G. Gallagher. Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.

The objective of this study was to examine the use of partial exchange transfusion (PET) performed for polycythemia hyperviscosity syndrome (PHS) over time. A retrospective review of 141 infants who received a PET for PHS at Yale-New Haven Hospital, between 1986-2007 was performed, querying maternal and neonatal medical records. Patient demographics, risk factors for PHS, indications for PET, and complications associated with PET and PHS were collected. Overall, there was no change in the number of PET performed over the study period (r2=0.082, p=0.192). Eighty-eight percent of patients had at least one risk factor for PHS, most commonly maternal diabetes. Over time, there was a statistically significant decrease in maternal diabetes as a risk factor for PHS. Forty percent of patients had a significant complication attributed to PHS prior to PET. Eighteen percent of patients had a complication attributed to PET. Life-threatening complications of PHS or PET were rare. In conclusion, PHS continues to be a problem observed in neonatal intensive care units, particularly in at-risk populations. PHS and PET are associated with significant complications. Well designed studies with long-term follow up are needed to assess the risks and benefits of PET for PHS.

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