Red cells for top-up transfusions
Studies support restrictive transfusion thresholds.
Suggested transfusion thresholds for preterm neonates
|Postnatal Age||Suggested transfusion threshold|
|Ventilated||On oxygen/NIPPV**||Off oxygen|
|1st 24 hours||<120||<120||<100|
|≤week 1 (day 1-7)||<120||<100||<100|
|week 2 (day 8-14)||<100||<95||<75*|
|≥week 3 (day 15 onwards)||<100||<85||<75*|
Table applies to very preterm babies (<32 weeks); for later preterm/term babies the values for babies off oxygen may be used.
* It is accepted that clinicians may use up to 85 g/L depending on clinical situation.
** NIPPV, non-invasive positive pressure ventilation.
Generally transfuse 15 mL/kg for non-bleeding neonates.
Where the term or preterm neonate does not require resuscitation, undertake delayed cord clamping.
Minimise phlebotomy where possible, using small volume samples.
Ensure that paedipacks are available for emergency use by maternity and neonatal units.
Transfuse red cells for large volume neonatal and infant transfusion before the end of Day 5
Transfusion rate: 5mL/kg/hr.