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INTRODUCTION

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Transfusion of blood components is essential for treating pediatric patients with a variety of disorders. Neonatal and pediatric transfusion practices are generally categorized by the following age groups: (1) infants up to 4 months of age, and (2) infants/children between 4 months and 18 years of age. This chapter addresses specific aspects of pediatric transfusion medicine, namely blood components, indications, physician ordering practices, component preparation in the blood bank, bedside administration, and potential adverse events related to each age group and blood component. It is important to note that prior to ordering or administering any blood product or component, informed consent explaining indications, treatment plan(s), benefits, and risks must be obtained unless a transfusion is required emergently.

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PACKED RED BLOOD CELLS

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Composition and Volume

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Packed red blood cells (pRBCs) are the most commonly transfused component of whole blood (WB). They are derived by centrifugation or, less frequently, acquired directly from a donor by an apheresis technique that produces non–WB–derived pRBCs. See Table 438-1 for types of pRBC products, volume per unit, hematocrit, and storage periods. Various anticoagulant solutions are used to preserve pRBCs and may uniquely affect each neonatal/pediatric recipient.

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TABLE 438-1abPACKED RED BLOOD CELL PRODUCTS
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