Abstract
Premature infants receive packed red blood cell (PRBC) transfusions to maintain a hemoglobin threshold, replace laboratory losses, or treat symptoms such as tachycardia, tachypnea, apnea, or growth failure (Kasat, Hendrickson-Munoz & Mally, 2011). There are no widely established parameters for PRBC transfusions in neonates, which leads to variations in practice. Some institutions have established unit specific guidelines, but the overall practice is based on the provider discretion. The development of an evidence-based practice guideline is intended to set a consistent, lower hemoglobin threshold at which neonates in the neonatal intensive care unit (NICU) receive PRBCs with a goal of decreasing the frequency of PRBC transfusions. Preventing short term and long term problems in the neonate is the ultimate desired outcome. This review will give an overview of the pathophysiology of the neonate receiving PRBCs, short and long term problems associated with neonatal PRBC transfusions, and restrictive versus liberal transfusion criteria. A retrospective chart review was performed describing the indications for patients that had received transfusions in the NICU at Mayo Clinic-Rochester during 2012. A Hemoglobin Threshold Transfusion Guideline was developed after extensive literature review.