Bridging the evidence-to-practice gap: Advancing neonatal blood transfusion. A narrative review of recent guidelines

Abstract

Neonates represent a distinct population within the context of transfusion medicine. Blood transfusions in neonates are vital interventions for multiple conditions, despite their inherent risks and potential complications. Differences in physiology and other transfusion risk factors unique to this group require careful adaptation of transfusion guidelines. This article seeks to offer a thorough overview of the current evidence-based practices for RBC administration in neonates. It covers the collection, processing and storage of RBCs and discusses the research underpinning the most recent transfusion guidelines. Furthermore, it emphasizes the challenges in establishing precise cut-off values for these conditions in both preterm and critically ill neonates and discusses indications for transfusion, thresholds, current guidelines, and potential complications. Finally, it highlights gaps in critical areas of transfusion related research and proposes future targets for research.