Transfuse for Hct less than or = 20%

• If asymptomatic, with retic < 100 bil/L

Transfuse for Hct less than or = 30%

• If receiving supplemental oxygen
• If on CPAP or mechanical ventilation
• If significant apnea noted (>24 episodes in or 2 episodes requiring bagging in 24h) and with therapeutic levels of methylxanthine
• If heart rate >180 or respiratory rate >80 persisting for 24h
• If weight gain < 10 g/d over 4d while receiving at least 100 kcal/kg/d
• If undergoing surgery

Transfuse for Hct less than or = 35%

• If receiving > 35% supplemental oxygen
• If intubated on CPAP or mechanical ventilation with MAP 6

Transfuse for Hct less than or = 40%

• Repeat transfusion from a previously used unit

These are guidelines arrived at by a consensus of the neonatologists of the University of Washington. We encourage any thoughtful variations from these guidelines.

Modified from: Shannon, K.M., et al. Recombinant human erythropoietin stimulates erythropoiesis and reduces erythrocyte transfusions in very low birth weight preterm infants. Pediatrics 95:1-8,1995.

This document was created and prepared for this Web site by:

• Thomas P. Strandjord, M.D., Assistant Professor
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