Anaemia and blood product transfusions

CHAPTER 16 Anaemia and blood product transfusions



Mark Davies, David Cartwright



Anaemia of prematurity


Newborn infants have decreased red blood cell (RBC) production and their haemoglobin concentration [Hb] falls in the weeks/months following birth. This normal fall in Hb is exaggerated in the preterm infant because of decreased erythropoietin production, decreased RBC survival, and blood loss due to frequent blood sampling. This results in anaemia of prematurity: common in preterm infants and universal in extremely low birth weight (ELBW) infants.


The clinical effects of anaemia include:


• increased respiratory effort or shortness of breath

• oxygen requirement not due to other obvious cause (such as chronic lung disease)

• poor weight gain.

When recovery from anaemia of prematurity occurs, iron stores are depleted quickly. Iron treatment is used to aid recovery from anaemia of prematurity (see page 76).


Erythropoietin has not been reliably demonstrated to prevent anaemia of prematurity or RBC donor exposure.



Top-up transfusion



• Always get consent for transfusion from parents before administering, and note this in the chart.

• Blood for neonatal ‘top-up’ transfusions is supplied in paediatric packs (paed packs). A single unit of donor RBC is split into 4 packs averaging ∼50 mL (25–100 mL). When a baby uses one of the 4 packs, the other 3 may be set aside for possible future use in that baby, thus limiting the number of donors the baby may be exposed to.
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Related posts:

  1. Fluids and nutrition
  2. Cranial ultrasounds
  3. Maternal thyroid disease
  4. Withdrawal of treatment

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Jul 18, 2016 | Posted by in PEDIATRICS | Comments Off on Anaemia and blood product transfusions

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