Technical issues in neonatal transfusions

Neonatal transfusions provide challenges at several steps in the process. Neonates are often transfused with relatively small volumes at slow flow rates from syringes,whereas at other times they require relatively massive transfusions or exchange transfusions. To facilitate these specialized transfusions, blood banks often modify their procedures to provide small volumes of blood components that are sometimes dispensed in syringes or to reconstitute whole blood for exchange transfusions. Hospitals must implement policies and procedures to ensure that the blood components are transfused safely when using these specialized techniques for infants. Nevertheless, some issues remain in many hospitals, such as the difficulty in safely warming blood components for neonatal transfusions and the difficulties in using approved labels for small containers that are sometimes prepared at the bedside. Immunohematology2008;24:4–9.