Transfusion therapy in neonatology

Overview

Transfusions are part of intensive care for newborns and their need is inversely proportional to gestational age. Most of the transfusions are indicated in order to achieve the established limits of the laboratory parameters of the blood count and coagulation examinations. Transfusion is associated with activation of immune reactions, inflammatory response and oxidative stress in newborns. Due to these adverse reactions, it is recommended to prefer a restrictive approach to the administration of transfusions. Indications for erythrocyte transfusion in preterm infants are evidence-based recommendations and take into account hemoglobin concentration, postnatal age of the infant, and ventilatory support. A recommendation for erythrocyte transfusion in full-term neonates is not available. There is not enough data to clearly determine the indications for the administration of fresh frozen plasma and platelets. Fresh frozen plasma should be administered to newborns with active coagulopathy bleeding. It is not recommended for replenishment of circulating volume and treatment of shock. Platelet transfusion should be indicated when the number of platelets is < 25 × 109/l. In special situations with a higher risk of severe bleeding, the administration of platelets should be considered even with a higher platelet count.

Keywords:

Platelets – newborn – plasma – transfusion – erythrocytes