BP: blood pressure; BUN: blood urea nitrogen; CBC: complete blood count; IV: intravenous; PET: partial exchange transfusion.
* Asymptomatic infants are included in this algorithm to provide guidance for situations when polycythemia is an incidental finding on laboratory testing performed for other reasons (eg, sepsis evaluation). We do not routinely measure the hematocrit to screen for polycythemia in term infants who appear well.
¶ Observation includes ongoing assessment of symptoms, monitoring intake, and measuring urine output and daily weight.
Δ The main rationale for administering IV hydration is to prevent hypoglycemia. Hypoglycemia is a common complication of polycythemia, particularly if the hematocrit is >70%. Dextrose-containing IV fluids are provided for the first 24 to 48 hours of age at a rate of at least 100 mL/kg per day (glucose infusion rate of 6 to 8 mg/kg per min), while the infant is closely monitored.
◊ The frequency of blood glucose and bilirubin testing depends on initial results. Refer to separate UpToDate content on neonatal hypoglycemia and hyperbilirubinemia for details.Do you want to add Medilib to your home screen?