Blood Transfusion In The Newborn

Introduction

Blood transfusion is the administration of blood for therapy.
Blood transfusion in the newborn is indicated by:

  • Acute haemorrhage
  • Anaemia

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.

Complications

  • 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,
    acidosis, hypothermia.
  • Circulatory overload is common.

The recommended measures include slowing of the drip rate and intravenous frusemide 1mg/kg.