Deschmann Emöke, Andersson Andreas, Frisk Tony, Magnusson Maria
med dr, biträdande överläkare, ME neonatologi, Astrid Lindgrens barnsjukhus; institutionen för kvinnors och barns hälsa, Karolins-ka institutet
med dr, överläkare,, ME barn perioperativ medicin och intensivvård, Astrid Lindgrens barnsjukhus; sektionen för anestesiologi och intensivvård, FYFA, Karolinska institutet.
Lakartidningen. 2021 Mar 16;118:20148.
Transfusions should be given for medical indications and based on the clinical context for the individual patient. Clinicians should follow the most current existing clinical guidelines. The neonatal hemostatic system differs significantly from that of children and adults. Still, healthy neonates have a balanced hemostatic system. Since the level of hemoglobin is critical to tissue oxygenation, it is important in the rapidly developing neonate. For preterm neonates, different red blood cell transfusion thresholds should be used based on postnatal age and illness severity. Most hemodynamically stable pediatric intensive care patients with a hemoglobin >70 g/L do not require transfusion. Pediatric massive transfusion protocols should exist in pediatric hospitals. At Karolinska University Hospital, red blood cells, fresh frozen plasma and platelets are transfused in a ratio of 20:20:10 mL/kg to children <50 kg. In liver disease, transfusions can lead to increased bleeding.
输血应基于医学指征并根据个体患者的临床情况进行。临床医生应遵循最新的现有临床指南。新生儿止血系统与儿童和成人的止血系统有显著差异。不过，健康新生儿具有平衡的止血系统。由于血红蛋白水平对组织氧合至关重要，在快速发育的新生儿中这一点很重要。对于早产儿，应根据出生后年龄和疾病严重程度使用不同的红细胞输血阈值。大多数血红蛋白>70 g/L且血流动力学稳定的儿科重症监护患者不需要输血。儿科医院应制定儿科大量输血方案。在卡罗林斯卡大学医院，对于体重<50 kg的儿童，红细胞、新鲜冰冻血浆和血小板的输注比例为20:20:10 mL/kg。在肝病中，输血可能导致出血增加。
