Akkök Çiğdem Akalın, Seghatchian Jerard
Department of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevaal, Oslo, Norway.
International Consultancy in Blood Components Quality/Safety improvement, Audit/Inspection, DDR Strategies London, UK.
Transfus Apher Sci. 2018 Jun;57(3):358-362. doi: 10.1016/j.transci.2018.05.019. Epub 2018 May 16.
The aim of pediatric transfusions should be based on the concept of avoiding unnecessary transfusions without jeopardizing the patient safety and providing correct blood components when there are well founded indications to transfuse. Despite considerable efforts from transfusion services to increase transfusion safety, transfusions are still associated with preventable and unpreventable adverse effects that may, in the worst case, have severe and fatal consequences. Transfusions to pediatric patients constitute a small proportion of all transfusions but have higher incidence of adverse events compared to adults. Pediatric transfusions consist of intrauterine transfusions, top-up transfusions to neonates and young children, exchange transfusions in the management of hemolytic disease of newborn (HDN), in addition to sickle cell crisis, chronic transfusion therapy in thalassemia patients, massive transfusion in trauma, HLA- and HPA-compatible platelets in immunized patients and neonates with fetal neonatal alloimmune thrombocytopenia (FNAIT). Packed red cells (PRCs) and platelet (PLT) concentrates are the most utilized blood components and will be reviewed here.
在不危及患者安全的情况下避免不必要的输血，并在有充分输血指征时提供正确的血液成分。尽管输血服务机构为提高输血安全性付出了巨大努力，但输血仍会带来可预防和不可预防的不良反应，在最坏的情况下，可能会产生严重和致命的后果。儿科患者的输血占所有输血的比例较小，但与成人相比，不良事件的发生率更高。儿科输血包括宫内输血、给新生儿和幼儿的补充输血、新生儿溶血病（HDN）管理中的换血输血，此外还有镰状细胞危象、地中海贫血患者的慢性输血治疗、创伤中的大量输血、免疫患者和患有胎儿新生儿同种免疫性血小板减少症（FNAIT）的新生儿的HLA和HPA相容血小板。浓缩红细胞（PRCs）和血小板（PLT）浓缩物是最常用的血液成分，本文将对此进行综述。
