Unique aspects of red blood cell transfusion in pediatric patients

Red blood cell transfusion plays an integral role in the management of the anemic child, and multiple factors must be considered when performing transfusions in children as compared with adults. The practitioner must be aware of the particular indication for transfusion, normal hemoglobin for age, and the need for special requirements based on the age and type of patient. Additionally, the practitioner must be aware of potential unique complications in the pediatric population and also ensure a system is in place in order to report and evaluate such potential adverse reactions. Here, we review the underlying physiological factors, symptomatology, transfusion guidelines, transfusion reactions, and potential side effects with an emphasis on those aspects that are unique to children with anemia. Many gaps remain in fully understanding pediatric red blood cell transfusion that should be addressed over time with continued research and hemovigilance.