why do premature babies need blood transfusions
вввввWhat is a blood transfusion? A blood transfusion is when a baby gets a blood product. The blood is usually given through an intravenous (IV). An IV is a small tube or needle that is put into a vein. A blood transfusion is usually given over four hours, but can be given faster if needed. Sometimes your baby can have a reaction to a blood transfusion. Your baby will be checked (e. g. , blood pressure, heart rate, breathing) often during the transfusion. Your baby will not feel any different during a blood transfusion. Doctors or nurse practitioners can order blood transfusions. Why does my baby need a blood transfusion? Your doctor will tell you why your baby needs a blood transfusion. Sometimes babies need a blood transfusion because they have anemia (less red blood cells than normal). What blood products can be transfused? Your baby will only get the part of the blood that is needed. The different parts of blood that can be transfused are
Red blood cells carry oxygen from the lungs to all parts of the body. All of the organs in the body (especially the heart, brain, and kidney) need oxygen to work properly. Platelets are small, sticky cells that make plugs on walls of vessels. This helps to prevent and/or stop bleeding. Plasma is the clear, liquid part of the blood that has proteins in it. These proteins help the blood to clot. Plasma can be given with platelets to prevent and/or stop bleeding. treat certain illnesses (e. g. , factors for hemophilia) help fight infections (e. g. , immunoglobulins) Where does the blood come from?
In Alberta, Canadian Blood Services (CBS) collects blood from healthy, volunteer donors. All donors are asked questions about health, travel, and social history before blood is collected. This is to make sure that the blood is as safe as possible. The blood that is donated is tested for different diseases. If there is a problem, the donor is not allowed to give blood again. Blood that does not pass testing is thrown away. After the blood is tested, it is separated into all of the different parts (e. g. , red blood cells, platelets). When a blood product is needed, a sample is collected from the person that needs the transfusion. Tests are done on the blood. This is to make sure that the personвs blood will match with the donated blood. Are blood transfusions safe? Hepatitis C - 1 in 2. 3 million Hepatitis B - 1 in 153,000 Can my baby get blood from a family member? Directed Donation is when someone donates blood to be given to a specific person (e. g. , a parent donating blood for a child). Directed donation is not always possible. Someone that wants to donate blood for a baby must meet the same standards as other blood donors. Your doctor can help to arrange a directed donation, if this is appropriate. If you have any questions or concerns, talk to your doctor (or whoever ordered your blood product). вввв Most hemorrhagic shock in newborn infants occurs at birth.
The condition is sometimes the result of a perinatal catastrophe or, occasionally, a surgical or instrumental complication. Concealed blood losses from antepartum hemorrhage or fetomaternal bleeding are difficult to evaluate and may share both acute and chronic components. Neonatal and perinatal blood loss from placental hemorrhage, twin-to-twin transfusion, fetomaternal hemorrhage, velamentous insertion of the cord or cord rupture differ from adult models of hemorrhagic shock in that bleeding is terminated by the delivery itself. Traumatic bleeding is rarely an ongoing contributor to hypotension. Recent advances in the management of adults have identified both the rapid and massive administration of fluids and the transfusion of stored RBCs as contributors to ongoing coagulopathy and further bleeding in uncontrolled traumatic hemorrhage. ( ) In massive transfusion, in which the transfused blood virtually replaces blood volume, multiple component transfusions with equal volumes of plasma, platelets and RBCs are effective in reducing the coagulopathies attributable to the loss of these components. However, there is little evidence at present to support this treatment approach as best practice. Perinatal hemorrhagic shock must be recognized and treated immediately. A general but unevaluated approach to emergency treatment includes partial restoration of the circulation with normal saline, at 10 mL/kg to 20 mL/kg, while awaiting the emergency provision of group O Rh-negative packed RBCs, which should be administered in similar volumes.
A hemoglobin level only provides guidance when chronic bleeding has occurred. The collection of cord or pretransfusion blood for typing is helpful. Large volumes of fluid and blood should be administered cautiously and in a staged process: initially and rapidly, to restore circulation; then secondly and prudently, to maintain adequate circulation and blood hemoglobin content. The administration rate for emergency transfusion depends on the critical state of the circulation, and may range from an initial 1 min push of 20 mL to later stabilization rates of 10 mL/kg/h, depending on the state of recovery. A major risk of rapid and massive transfusion is hyperkalemia. Saline, adenine, glucose and mannitol-prepared blood has an additional supernatant potassium content of approximately 1 mmol/L/day of storage and, therefore, may approach 50 mmol/L at 42 days. This potassium load is rapidly distributed after transfusion and subsequent RBC uptake may even cause hypokalemia. ( ) A threshold hemoglobin level for further transfusion has not yet been determined. A theoretical and unevaluated minimum is in the order of 60 g/L. ( ) The use of cord blood for emergency transfusion has not been evaluated. (
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