Abstract
In the management of the new born, the so-called hyperviscosity syndrome is becoming problematic and in the high hematocrit group of over 65% circulatory obstruction and cyanose appear. We recognized symptoms of hypercoagulability namely an increase of fibrinogen and SFMC (soluble fibrin monomer complex) and followed the changes of coagulation fibrinolysis system after heparin therapy and partial exchange transfusion.
Method In 20 cases of newborn with a 65% or over hematocrit value and an increase in SFMC, 10 cases were treated with heparin and 10 cases were given partial exchange transfusion with fresh frozen plasma. Measurement on the following were made: (i) fibrinogen volume, (ii) SFMC, (iii) platelet aggregation (iv) PT. PTT, (v) TEG, (vi) antithrombin III, (vii) erythrocytoblast, (viii) ELT, , and (ix) FDP.
Results In the partial exchange transfusion group, in 3 cases which showed hematocrit values of over 75%, a remarkable increase in erythrocytoblast, and a strong hemolysis and a high anemia was seen. Partial exchange transfusion was done but a sudden shortening of ELT was seen during operation. Post operatively with a lowering of SFMC and hematocrit values improvement of clinical signs were seen.
In the heparin treated group, as a result of a 100-150 units/kg heparin injection a decrease in SFMC was seen and antithrombin III showed a 60% decrease of that prior to treatment.
