The article by Ramamurthy and Brans (Pediatrics 68:168, 1981) on the criteria for diagnosis and treatment of neonatal polycythemia was most interesting. Their conclusions that there are considerable and unpredictable differences between capillary, peripheral, venous, and umbilical venous hematocrit levels in the same neonate might be of much importance in deciding on which neonate to treat. It might be justified, as they suggested, in performing an umbilical vein hematocrit and blood vincosity determination before deciding whether to continue with a partial exchange transfusion in an infant with a venous hematocrit of 65% or greater.

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