Transfusion of red blood cells (RBCs) can be life-saving in patients with severe blood loss or patients with severe chronic anemia. On the other hand, RBC transfusion has significant risks, including volume overload, transmission of infectious agents, transfusion reactions, and various immunologic consequences including graft-versus-host disease.
The indications for RBC transfusion in infants and children will be reviewed. The selection of the proper blood components, methods of administration, the complications of RBC transfusion and issues concerning blood donation and laboratory testing of donated blood are discussed separately. (See "Red cell transfusion in infants and children: Selection of blood products" and "Administration and complications of red cell transfusion in infants and children" and "Blood donor screening: Medical history" and "Blood donor screening: Laboratory testing" and "Red blood cell compatibility testing (crossmatching)".)
PREVALENCE OF PEDIATRIC RED CELL TRANSFUSION
The transfusion rate for any blood component in hospitalized children remains uncertain. In children hospitalized at academic children's hospitals, the rate of transfusion of either RBCs or platelets is approximately 5 percent.
This was best illustrated at a multicenter study from the Pediatric Health Information System of hospitalized patients who were 18 years or younger between 2001 and 2003 cared for at 35 academic children's hospitals . Of the approximately one million hospitalized children in this database, RBC transfusions were performed in 4 percent and platelet transfusions in 1 percent of the patients. The distribution of transfusion based upon age was as follows:
●Neonates (patients less than 30 days of age) - 17.5 percent