ComplicationsĬomplications may occur as a result of bleeding, thrombosis or sepsis and may result in neurological deficit, heart failure and renal failure. The underlying cause of the hyperviscosity syndrome may be treated with chemotherapy where appropriate. In patients who are drug-resistant this may be indicated as long-term management. 1-2 procedures are advised for the treatment of hyperviscosity syndrome in Waldenström's macroglobulinaemia. In adult patients, plasmapheresis to remove excess numbers of cells or circulating complexes remains the treatment of choice.26 For patients with high blood viscosity, intravenous hydration with normal saline before phlebotomy is advised. Infants may be treated using partial exchange transfusion. Research published in the Aviation, Space, and Environmental Medicine journal demonstrated that dehydration increases systolic blood viscosity by 9.3 and diastolic blood viscosity by 12.5.This may increase the risk for veno-occlusive events. Unfortunately, repeated procedures may lead to iron deficiency, resulting in microcytic erythrocytes, which induce higher viscosity than normocytic erythrocytes.Some conditions producing hyperviscosity may be helped by regular venesection - eg, polycythaemia rubra vera.Furthermore small increases in hematocrit may be beneficial due to the related increase in blood viscosity, independently of the increase of oxygen delivery capacity. Patients with a hyperviscosity syndrome should be advised that this may recur they should be advised to look for signs of bleeding or infection. Hyperviscosity syndrome (HVS) is a combination of clinical signs and symptoms related to increased blood viscosity. It is concluded that although hemodilution is indicated for reducing abnormally high blood viscosities, it is beneficial to increase plasma viscosity when hematocrit is reduced.
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