Partial plasma exchange transfusion in polycythaemic neonates

You are a neonatal junior doctor looking after the special care nursery. You process a capillary blood sample taken on the morning blood round by someone who has now gone home, and find the haematocrit to be high at 69%. You go back to the baby and find the child to be term, of low birth weight, and admitted to the special care nursery because of low Apgars the previous day. He has not been feeding too well, but the neonatal nurses are not otherwise concerned. He is normal on examination, and his venous haematocrit comes back at 68%. Does this baby need a partial plasma exchange transfusion (PPET)? In an asymptomatic neonate with an incidental finding of raised venous haematocrit [patient], does treatment with …