Pediatric And Neonatal Transfusion Practices |
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A number of transfusion practices are modified for premature infants and full-term neonatal patients (i.e. younger than 4 months). Guidelines specific for these patients are provided below.
Criteria for Transfusion of Red Blood Cells for Neonates
- Hemoglobin level < 13 g/dL in neonates < 24 hours old.
- Hemoglobin level < 13 g/dL & severe pulmonary disease, cyanotic heart disease, or heart failure.
- Acute blood loss of 10% of total blood volume.
- Phlebotomy losses of 5-10% of the total blood volume.
- Hemoglobin level < 8 g/dL in stable newborn infants with clinical manifestations of anemia.
Criteria for Transfusion of Granulocyte Concentrates
- Bacterial sepsis in neonates < 2 weeks of age with neutrophil plus band count < 300/m L.
- Bacterial sepsis unresponsive to antibiotics in patients >2 weeks of age with neutrophil plus band count < 500/m L.
- Documented infections unresponsive to antibiotics plus a qualitative neutrophil defect, regardless of the neutrophil plus band cell count.
Criteria for Transfusion of Platelets in Premature Infants (gestational age < 37 weeks)
- Platelet count < 50,000/m L in a stable infant.
- Platelet count < 100,000/m L in a sick infant.
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