PubMed · 15258339
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Sandro Forconi. 2004. From hyperviscosity to endothelial dysfunction: a return trip?. https://pubmed.ncbi.nlm.nih.gov/15258339/
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BACKGROUND: Severe polycythaemia in the neonate may produce symptoms due to hyperviscosity and may be associated with serious complications. Partial exchange transfusion will reduce the packed cell volume. OBJECTIVE: To determine whether partial exchange transfusion in term infants with polycythaemia (symptomatic and asymptomatic) is associated with improved short and long term outcomes. SEARCH STRATEGY: Medline, EMBASE, and the Cochrane Controlled Trials Register of the Cochrane Library were searched. The following keywords were used: polycythaemia, partial exchange transfusion, hyperviscosity, and limited to the newborn. This covered years 1966-2004. Abstracts of the Pediatric Academic Societies and personal files were also searched. SELECTION CRITERIA: Randomised or quasi-randomised trials in term infants with polycythaemia and/or documented hyperviscosity were considered. Clinically relevant outcomes included were short term (resolution of symptoms, neurobehavioural scores, major complications) and long term neurodevelopmental outcome. DATA COLLECTION AND ANALYSIS: All data for each study were extracted, assessed, and coded separately. Any disagreements were resolved by discussion. MAIN RESULTS: Six studies were identified; five had data that could be evaluated for analysis. There is no evidence of an improvement in long term neurological outcome (mental developmental index, incidence of mental delay, and incidence of neurological diagnoses) after partial exchange transfusion in symptomatic or asymptomatic infants. There is no evidence of improvement in early neurobehavioural assessment scores (Brazelton neonatal behavioural assessment scale). Partial exchange transfusion may be associated with an earlier improvement in symptoms, but there are insufficient data to calculate the size of the effect. Necrotising enterocolitis is probably increased by partial exchange transfusion (relative risk 8.68, 95% confidence interval 1.06 to 71.1). CONCLUSION: There is no evidence of long term benefit from partial exchange in polycythaemic infants, and the incidence of gastrointestinal injury is increased. The long term outcome is more likely to be related to the underlying cause of polycythaemia.
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We have developed a microfabricated nanoliter capillary viscometer that quickly, easily, and inexpensively measures the viscosity of liquids. The measurement of viscosity is based on capillary pressure-driven flow inside microfluidic channels (depth approximately 30 microm and width approximately 300 microm). Accurate and precise viscosity measurements can be made in less than 100 s while using only 600 nL of liquid sample. The silicon-glass hybrid device (18 mm by 15 mm) contains on-chip components that measure the driving capillary pressure difference and the relevant geometrical parameters; these components make the nanoliter viscometer completely self-calibrating, robust, and easy to use. Several different microfabricated viscometers were tested using solutions with viscosities ranging from 1 to 5 cP, a range relevant to biological fluids (urine, blood, blood plasma, etc.). Blood plasma samples collected from patients with the symptoms of hyperviscosity syndrome were tested on the nanoliter capillary viscometer to an accuracy of 3%. Such self-calibrating nanoliter viscometers may have widespread applications in chemical, biological, and medical laboratories as well as in personal health care.