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Updated: Jun 28, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Transfusion therapy in critically ill children.

Tai-Tsung Chang¹

¹Pediatric Hematology/Oncology, Kaohsiung Medical University Hospital and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. tatsch@cc.kmu.edu.tw

Pediatrics and Neonatology

|October 25, 2008

Summary

Pediatric blood transfusions require individualized guidelines due to children's unique physiology. Focus on treating underlying conditions and using targeted replacement therapies to minimize risks and optimize outcomes for critically ill children.

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Last Updated: Jun 28, 2026

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

Published on: March 14, 2017

Area of Science:

Pediatric critical care medicine
Transfusion medicine
Hematology

Background:

Critically ill children in pediatric intensive care units (PICUs) often require blood transfusions for various reasons.
Children's growth and development differ significantly from adults, necessitating tailored transfusion approaches.
Establishing universal transfusion guidelines for critically ill children, especially preterm neonates, is challenging.

Purpose of the Study:

To review current approaches and considerations for blood product transfusion in critically ill children.
To highlight the importance of individualized treatment strategies over universal guidelines.
To discuss methods for minimizing transfusion risks and improving patient safety.

Main Methods:

Review of existing literature and clinical practices regarding pediatric transfusion.
Analysis of specific transfusion indications for red blood cells, platelets, and plasma products.
Discussion of strategies to mitigate transfusion-related risks, including alternative therapies and product modifications.

Main Results:

Red blood cells are primary for anemic patients; critical hemoglobin levels may be higher in critically ill children.
Platelet transfusion criteria vary based on bleeding status, risk factors, and age, with specific considerations for neonates.
Treatment of underlying diseases is key for hemorrhagic conditions and disseminated intravascular coagulation (DIC); recombinant factors offer alternatives.

Conclusions:

Individualized transfusion strategies, focusing on underlying disease treatment and targeted replacement, are crucial for critically ill children.
Minimizing blood exposure through alternative therapies (e.g., erythropoietin) and advanced product modifications (e.g., leukoreduction) enhances safety.
Adherence to principles of avoiding complications, reducing exposure, and maintaining agent safety is paramount in pediatric transfusion medicine.