So you’re in peds and your patient is anemic. You need to transfuse, but you are confused. How much blood do you give? How fast do you give it?
How much:
The volume of blood to be transfused may vary depending on the clinical scenario. The transfusion volume is usually 10 to 15 mL/kg. Infants generally have higher blood volumes per kg compared with older children and may need transfusion volumes on the higher end of the range to achieve the desired hb concentration.
How fast:
Blood issued for transfusion should be infused within 4 hours. More rapid infusion may be appropriate when there is acute blood loss and HD instability. If you need to infuse blood slowly, the blood bank can send you smaller aliquots of blood so that you can infuse a small amount over 4 hrs. Whatever you dont use in 4 hrs theoretically should not be used. Transfusion at a rate of approximately 2.5mL/kg/hr is standard and usually avoids circulatory overload. Patients deemed at risk for volume overload such as those with impared cardiac function can be transfused at a slower rate of 1mL/kg/hr.
