Guidelines for Red Cell Transfusion


Reviewed by Jane Harding
Clinical Guidelines Back Newborn Services Home Page
Causes of Anaemia Indications for Transfusion Consent Ordering Multipacks
Transfusion Volume Other Related Documents References

Common Causes of Neonatal Anaemia

Although these factors combine to result in the ‘normal’ fall in haemoglobin concentration in the first 6-9 weeks after birth, this is accompanied by improved oxygen unloading capacity as 2,3-DPG levels rise, so that tissue oxygen delivery may improve despite reduced oxygen carrying capacity. Thus the possible benefits of transfusion need to be balanced against the known (and unknown) risks for each individual baby.

Indications for Transfusion

  1. Shock due to blood loss.
  2. Babies with cardiorespiratory disease.
    Transfuse if haematocrit:
  3. Stable growing babies < 6 weeks old.
  4. Stable growing babies > 6 weeks old.


Ordering Multipacks

Transfusion Volume


1 Stefano JL and Bhutani VK. Role of furosemide therapy after booster-packed erythrocyte transfusions in infants with bronchopulmonary dysplasia. J Pediatr 1990;117, 965-8.
2 Stute H, Greiner B, Linderkamp O. Effect of blood transfusion on cardiorespiratory abnormalities in preterm infants. Arch Dis Child 1995; 72: F194-6.
3 Yu VYH and Gan TE. Red cell transfusion in the preterm infant. J Pediatr Child Health 1994; 30;301-9.
4 Fetus & Newborn Committee, Canadian Paediatric Society. Guidelines for transfusion of erythrocytes to neonates and premature infants. Can Med Assoc J 1992; 147: 1781-6.