• A. Perform a double-volume exchange transfusion
  • B. Initiate phototherapy
  • C. Perform a partial exchange transfusion ✓
  • D. Administer intravenous immunoglobulin (IVIG)
  • E. Perform a triple lindy


In infants with polycythemia and symptoms secondary to hyperviscosity, most centers would perform a partial exchange transfusion. This procedure involves removing a portion of the infant’s blood and replacing it with donor blood or a blood product such as albumin or saline.

In other words, Partial Exchange Transfusion (PET) is a medical procedure used in neonates, particularly those with polycythemia, to reduce the concentration of red blood cells and lower the hematocrit levels. This process involves removing a portion of the infant’s blood and replacing it with either donor blood or a solution like Normal Saline. The aim is to improve blood flow, prevent complications associated with high hematocrit levels, and enhance tissue perfusion.

The ICU Clinical Pathway for Infants Requiring Partial Volume Exchange Transfusion outlines the steps involved in performing a partial exchange transfusion for neonates with conditions such as polycythemia. It includes risk assessment, volume calculations, obtaining consents, post-procedure lab schedules, and follow-up recommendations. The pathway aims to standardize the approach to managing infants requiring PET and improve patient outcomes.

Partial exchange transfusion is considered less risky than double-volume exchange transfusion, which involves replacing the infant’s entire blood volume, and is often sufficient to alleviate symptoms of hyperviscosity in infants with polycythemia.

Performing a double-volume exchange transfusion may be reserved for cases where the infant’s symptoms are severe and not adequately controlled by other measures. Initiation of phototherapy may be indicated in cases where the infant has hyperbilirubinemia (jaundice) as a result of polycythemia. Administering intravenous immunoglobulin (IVIG) is not typically used in the management of polycythemia in infants.

Performing a “triple lindy” is not a recognized medical procedure and is likely included in the list as a distractor.

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