Blood transfusion is the administration of blood for therapy.
Blood transfusion in the newborn is indicated by:
- Acute haemorrhage
For haemorrhage, the decision to transfuse should be based on the infant’s
haemodynamics – pulse, blood pressure -and not on haematocrit which is usually normal immediately after haemorrhage.
Cross-match is desirable only if the condition is not life-threatening, otherwise fresh Group O Rhesus negative must be obtained for urgent transfusion.
For anaemia, transfusion is recommended when:
- PCV is <36% and infant is critically ill;
- PCV is <30% and infant is stable or surgery is urgently needed;
- cardiac failure is present and can be attributed only to anaemia.
When severe anaemia occurs within the first week of life, single volume exchange blood transfusion with 80ml/kg of fresh cross matched blood is recommended.
- Transfusion reactions are extremely rare in the newborn.
- Risk of transmission of infections (HIV, Hepatitis B Virus, Hepatitis C Virus, CMV) is germane
- Hyperkalaemia, Hypocalcaemia,
- Circulatory overload is common.
The recommended measures include slowing of the drip rate and intravenous frusemide 1mg/kg.