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NEONATAL TRANSFUSION
MessageThis test should be ordered on a patient that is under 4 months old and has had a type and screen (TYSR) performed.
Test Code
LAB30430
CPT Codes
Varies
Instructions
Ordered/Received in Sunquest by Blood Bank only.
Methodology
Hemogglutination/Hemolysis and/or Electronic Crossmatch
Setup Schedule
Sunday-Saturday
Clinical Significance
Audit criteria for neonatal (<4 months) transfusion include the following:
Red blood cells
• Hemoglobin < 8 g/dL in a stable newborn infant with clinical features of anemia such as tachycardia, bradycardia, tachypnea, apnea, etc.
• Hemoglobin < 10 g/dL and in an intensive care setting: This may include patients with impending respiratory failure or in the perioperative period.
• Hemoglobin < 13 g/dL and in the 1st day of life or with a serious medical condition: These conditions may include sepsis, respiratory
failure, cyanotic heart disease, etc.
• Hemoglobin < 15 g/dL in a term infant with severe respiratory disease requiring mechanical ventilation
• Acute blood loss of >10% of blood volume due to bleeding or phlebotomy.
• Chronic or acute transfusion in sickle cell disease, thalassemia or other red cell disorders
Reconstituted whole blood
• Exchange transfusion
• ECMO and cardiopulmonary bypass
• Replacement of more than one blood volume in 24 hours
Platelets
• Premature infants (< 34 weeks gestation or birth weight < 2000 grams)
a) Platelet count <50,000/μl in stable preterm infant
b) Platelet count < 100,000/μl in sick premature infant or after cardiopulmonary bypass with bleeding
• Larger infants (> 34 weeks gestation or birth weight > 2000 grams)
a) Platelet count <20,000/μL
b) Platelet count <50,000/μL with active bleeding or before an invasive procedure
c) Platelet count < 100,000/μl in patients following cardiopulmonary bypass
Fresh frozen plasma
• Same criteria as for adult patients, adjusted for difference in normal range: This may include documented or suspected plasma clotting
disorders in patients who are bleeding. FFP may also be used to replace antithrombin, protein C, or protein S when levels of these
proteins are less than 50% of normal.
Cryoprecipitate
• Deficiency or dysfunction of fibrinogen (< 100 mg/dL) or Factor 13 (<50% normal activity) as documented in the medical record or by
laboratory values.
Please refer to WVUH Transfusion Audit Criteria for more information.
Red blood cells
• Hemoglobin < 8 g/dL in a stable newborn infant with clinical features of anemia such as tachycardia, bradycardia, tachypnea, apnea, etc.
• Hemoglobin < 10 g/dL and in an intensive care setting: This may include patients with impending respiratory failure or in the perioperative period.
• Hemoglobin < 13 g/dL and in the 1st day of life or with a serious medical condition: These conditions may include sepsis, respiratory
failure, cyanotic heart disease, etc.
• Hemoglobin < 15 g/dL in a term infant with severe respiratory disease requiring mechanical ventilation
• Acute blood loss of >10% of blood volume due to bleeding or phlebotomy.
• Chronic or acute transfusion in sickle cell disease, thalassemia or other red cell disorders
Reconstituted whole blood
• Exchange transfusion
• ECMO and cardiopulmonary bypass
• Replacement of more than one blood volume in 24 hours
Platelets
• Premature infants (< 34 weeks gestation or birth weight < 2000 grams)
a) Platelet count <50,000/μl in stable preterm infant
b) Platelet count < 100,000/μl in sick premature infant or after cardiopulmonary bypass with bleeding
• Larger infants (> 34 weeks gestation or birth weight > 2000 grams)
a) Platelet count <20,000/μL
b) Platelet count <50,000/μL with active bleeding or before an invasive procedure
c) Platelet count < 100,000/μl in patients following cardiopulmonary bypass
Fresh frozen plasma
• Same criteria as for adult patients, adjusted for difference in normal range: This may include documented or suspected plasma clotting
disorders in patients who are bleeding. FFP may also be used to replace antithrombin, protein C, or protein S when levels of these
proteins are less than 50% of normal.
Cryoprecipitate
• Deficiency or dysfunction of fibrinogen (< 100 mg/dL) or Factor 13 (<50% normal activity) as documented in the medical record or by
laboratory values.
Please refer to WVUH Transfusion Audit Criteria for more information.
Performing Laboratory
West Virginia University Hospitals, Inc.
