Maximum transfusion rates in neonates and infants

A common method of rapid transfusion in neonates and infants is to manually inject an appropriate volume of blood using a syringe connected to a 3-way tap in the infusion tubing. We measured the maximum infusion rates this technique could generate through small bore cannulae (22 ga-25 mm, 24 ga-19 mm), and compared the efficiency of a range of syringe sizes. We also compared infusion rates generated by this technique with those obtained using a pressure pump chamber in the giving set. The manual syringing technique using a 10 ml syringe was the most efficient for all the fluids tested, providing infusion rates through the 22 ga cannulae of 64 ml/min for packed cells, 73 ml/min for whole blood and 105 ml/min for 0.9% saline.