Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Log In

    Show
    Forgot your password?
    Log In
    Or create a new account (it's free)

    Forgot Password?

    Enter your email address and we'll send you a link to reset your password.

    Get New Password

    Sign In Required

    To save favorites, you must log in.

    Creating an account is free, easy, and takes about 60 seconds.

    Already have an MDCalc account?

    Login to link your favorites and recently used calcs

    Show
    Forgot your password?
    Log In
    Or continue to Nuance

    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Neonatal Partial Exchange for Polycythemia

    Estimates the volume of whole blood to remove and volume of crystalloid to infuse in neonatal polycythemia.

    IMPORTANT

    This dosing tool is intended to assist with calculation, not to provide comprehensive or definitive drug information. Always double-check dosing of any drug and consult your institution's blood bank or a pharmacist as necessary.

    When to Use
    Pearls/Pitfalls
    Why Use

    Neonatal polycythemia can occur during the first week of life, when the hematocrit is >65% or hemoglobin >22 g/dL. The increased viscosity associated with polycythemia impairs tissue oxygenation and can lead to congestive heart failure, CNS, pulmonary and renal complications or necrotizing enterocolitis (NEC). Partial exchanges can be used to achieve a decrease in hematocrit (generally a goal of 55-60% to avoid complications associated with large decreases) by replacing whole blood with crystalloid. Plasma replacement is generally avoided due to an association with NEC.

    • Crystalloid replacement is used due to an association between plasma replacement and NEC.
    • Neonatal blood volume can be estimated as 85 mL per kg for full term neonates and 100 mL per kg for premature neonates. 

    Calculating the volume of whole blood for replacement by crystalloid can help achieve normalization of neonatal hematocrit and avoid complications associated with polycythemia.

    oz
    Pre-term
    Term
    %
    %

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Content Contributors
    • Alex Ryder, MD, PhD
    • Caleb Cheng, MD
    • Christopher Tormey, MD
    Content Contributors
    • Alex Ryder, MD, PhD
    • Caleb Cheng, MD
    • Christopher Tormey, MD