Immunohematological procedures and blood component selection in premature and mature infants

In the present review, we discuss how iatrogenic blood loss through immunohematologic testing can be minimized in preterm and mature infants. In this context, the main cause of red blood cell (RBC) concentrate transfusion is iatrogenic blood loss due to diagnostic blood sampling. In an observational study, the median iatrogenic blood loss in preterm infants during the first 28 days of life was 24.2 mL/kg compared with the transfused RBC volume of 30 mL/kg during the same period 1 . Thus, reduction of diagnostic blood sampling is an efficient measure to reduce RBC concentrate transfusions in preterm infants. Evidence-based immunohematologic testing can reduce blood loss, avoid transfusions, and reduce the costs incurred. Furthermore, we present how the occurrence of adverse events in neonatal transfusion can be prevented by evidence-based selection of blood components and suggest discussing more restrictive indications for transfusion, especially in premature infants.