HYPERVISCOSITY OF THE BLOOD AND HAEMOSTASIS IN THE NEWBORN INFANT

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Abstract
Newborn infants (15) with hyperviscosity syndrome due to polycythemia, i.e., a central hematocrit of at least 65% and a raised whole blood viscosity, were examined for changes in their coagulation and fibrinolytic systems. Five were thrombocytopenic but showed no other signs of activated coagulation. Neither did the only patient with positive ethanol gelation test measuring circulating fibrin monomers. Minute amounts of fibrin/fibrinogen degradation products (FDP) appeared in only 2 and, with only 1 exception, an assay for fibrinolytic activity in plasma was negative. No defects were found in the coagulation system. In most patients there was no demonstrable abnormal proteolysis in the circulation. In such infants the normally low levels of antithrombin III (heparin cofactor activity) in combination with the impairment of the microcirculation might increase the risk of thrombotic complications. Hemodilution, preferably with plasma, is therefore advocated in the symptomatic patients.