A neonate delivered at 38 weeks of gestation with a bih weight of 2.2 kg develops intolerance to feed/ abdominal distension on second day. Physical examination is unremarkable. Sepsis screen is negative. PCV is observed to be 72%. Which of the following represents the best management option ?
Ans is 'b' i.e., Paial Exchange Transfusion o PCV 72% in a neonate suggests the diagnosis of neonatal polycythemia. o Polycythemia is defined as central venous hematocrit Ialso called packed cell volume (PCV) or erythrocyte volume fraction (EVF)J level ofgreater than 65%. o The neonate in question is also having intolerance to feed and abdominal distension. So, this neonate is having symptomatic neonatal polycythemia. Treatment of neonatal polycythemia Therapy in newborns with polycythemia is based on both the measured central venous hematocrit level and the presence or absence of symptoms. (1) Symptomatic polycythemia o Paial exchange transfusion is the treatment of choice. (2) Asymptomatic polycythemia o In asymptomatic polycyhthemia, treatment depend upon hematocrit level (PCV). PCV 65-75% Perform cardiorespiratory monitoring and monitoring of hematocrit and glucose levels every 6-12 hours and observe the patients for symptoms If hematocrit (PCV) becomes more than 75%, consider paial exchange transfusion (PET). (ii) PCV> 75% o Paial exchange transfusion (PET) is the treatment of choice.
Hydration with IV Fluids
Paial Exchange Transfusion
Presumptive treatment for sepsis
Medical Management for intestinal obstruction