normal hemoglobin and hematocrit levels in neonates

PubMed clinical series algorithms for therapy, diagnosis and prognosis were used, as appropriate, to explore each of the statements attributed with a level of evidence. The literature published on this topic between 19 was reviewed using MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Controlled Trials Register. The environment and culture of blood transfusion have changed significantly since the emergence of HIV-AIDS, with advances in transfusion medicine and subsequent reductions in donor exposure and risk leading to increasing confidence in the blood supply. The most frequent indications for blood transfusion in the newborn are for the acute treatment of perinatal or surgical hemorrhagic shock and as ‘top-ups’ for the recurrent correction of anemia of prematurity. Indications for exchange transfusion are not addressed in the present statement.

The specific goals of safely reducing transfusion exposures while avoiding both acute and chronic consequences of RBC depletion have been influenced since 2002 by findings reported in comprehensive clinical trials - and a Cochrane review. The objective of the present statement, which replaces a previous Canadian Paediatric Society document published in 2002, is to provide evidence-based recommendations for the use of RBC transfusions in newborn infants. Neonatal intensive care, particularly for very low birth weight infants, is characterized by the frequent use of red blood cell (RBC) transfusions. Key Words: Anemia Blood grouping Cross-matching Erythrocyte Hemorrhagic shock Hyperkalemia Although the risks of transfusion have declined considerably in recent years, they can be minimized further by carefully restricting neonatal blood sampling.

There is weak evidence that cognitive impairment may be more severe at follow-up in extremely low birth weight infants transfused at lower hemoglobin thresholds therefore, these thresholds should be maintained by transfusion therapy. Some guidelines are now available from clinical trials investigating transfusion in anemia of prematurity however, considerable uncertainty remains. Perinatal hemorrhagic shock requires immediate treatment with large quantities of red blood cells the effects of massive transfusion on other blood components must be considered. The most frequent indications for blood transfusion in the newborn are the acute treatment of perinatal hemorrhagic shock and the recurrent correction of anemia of prematurity. The present position statement addresses the methods and indications for red blood cell transfusion of the newborn, based on a review of the current literature.

Red blood cell transfusion is an important and frequent component of neonatal intensive care. Paediatr Child Health 2014 19(4) 213-17 Abstract Robin K Whyte, Ann L Jefferies Canadian Paediatric Society, Fetus and Newborn Committee

Normal hemoglobin and hematocrit levels in neonates