Neonatal Red Cell Transfusion

Neonatal red cell transfusion is the transfusion of red blood cells to a neonate, a baby up to 28 days old. Most extremely preterm babies, born before 28 weeks, require at least one red cell transfusion, partly because of the blood removed through blood sampling relative to the baby's small total blood volume, called iatrogenic anemia, and partly because of anemia of prematurity, whose possible effects can include poor growth, lethargy and episodes of apnea. Most transfusions are given as small-volume top-up transfusions to raise a baby's hemoglobin above a set level, or because the baby is unwell as a result of the anemia. A related exchange blood transfusion is used to treat a rapidly rising bilirubin level that fails to respond to phototherapy or intravenous immunoglobulin, usually caused by hemolytic disease of the newborn but sometimes by another cause such as G6PD deficiency.