Perioperative Care Newborns/Infants — Blood Bank Orders — Clinical Pathway: ICU and Inpatient

Newborn/Infant Perioperative Care Clinical Pathway — N/IICU

Blood Bank Orders and Transfusion Recommendations

Packed Red Blood Cells (PRBC)
  • Consider if Hgb < 10 g/dL
  • All infants undergoing intracranial/intrathoracic/intraabdominal procedures:
    • Hgb ≥ 10 g/dL: 1 unit PRBC (divided into two aliquots) on hold
    • Hgb < 10 g/dL: Preop transfusion ordered
  • Infants undergoing a case with minimal expected blood loss (e.g., hernia repair or bronchoscopy):
    • Hgb 8-10 g/dL is acceptable
Platelets
  • Plt < 100,000 μl:
    • Order on hold
  • Discuss with surgical attending and anesthesia attending if preop transfusion is needed
Fresh Frozen Plasma (FFP)
  • In general, ordered for OR if coagulopathic
  • Or
  • Procedures with potential for increased bleeding
    • e.g., SCT resection, laparotomy for ostomy takedown/lysis of adhesions
  • Discuss with surgical and anesthesia attendings
Other
  • Sacrococcygeal Teratoma Resection:
    • Consider one dose factor VIIa recombinant (Novo-seven®)