Techniques for warming red blood cells packaged in different containers for neonatal use

Essential to the management of the sick, low birth weight infant is maintenance of a neutral thermal environment by use of convection incubators and radiant warmers. Manipulation of the infant in preparation for transfusion and the transfusion of cold blood could theoretically lower the infant's body temperature, subsequently contribute to cold stress, and concomitantly increase metabolic demands and oxygen requirements. The authors evaluated different pretransfusion manipulations of syringe aliquots and bags of blood in an effort to provide a clinically acceptable product for transfusion to sick, very low birth weight infants.