Background: Polycythemia in the newborn is defined as a central venous Hct over 65% or a haemoglobin value above 22g/dl. As the viscosity increases, there is an impairment of tissue oxygenation and perfusion and a tendency to form micro thrombi. Significant damage may occur if these events occur in the cerebral cortex, kidneys and adrenal glands. Hence this condition requires urgent diagnosis and prompt management however the choice of replacement fluid remains controversial.

Objective: To assess the hematocrit at 0, 6, 24 hours after partial exchange transfusion with normal saline and fresh frozen plasma and to compare the effects is both the two groups.

Method: The study was performed in neonatal care unit, Department of Pediatrics VIMSAR Burla from October 2016-september 2018. 29 Neonates matching the inclusion criteria were enrolled for this randomised controlled trial having two arms NS arm(neonates in whom NS was used as replacement fluid for PET) and FFP arm(neonates in whom FFP was used as replacement fluid). The various parameters were measured at 6 hour and 24 hour of exchange transfusion and compared between the groups.

Results: There was overall no significant difference in the hematocrit, hemoglobin values measured at 6 hour,24 hour after PET  in both the groups .Similarly in other parameters also there was no significant difference between both the groups. However, the interval between the diagnosis and treatment in NS group was less as compared to FFP group and came out to be significant as p value<0.00. The cost expenses of using FFP was more than that of NS which also was stastistically significant.

Conclusion: PET with normal saline is as safe and effective as Fresh Frozen Plasma as there was no clinically or statistically significant difference between them. Normal saline was cheap, readily available and effective substitute for management of neonates with polycythemia as compared to FFP and hence should be considered as an ideal replacement fluid for PET.

Keywords: PET-Partial exchange transfusion, NS-Normal saline, FFP-Fresh frozen plasma.

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Dr Rupashree Behera

VSSIMSAR Burla