Patient Blood Management in Pediatric Patients: Current Strategies and Future Perspectives

Area of Science:

• Hematology
• Pediatric Critical Care
• Transfusion Medicine

Background:

• Patient blood management (PBM) is a multidisciplinary approach to optimize transfusion care, widely adopted in adults but underutilized in pediatrics.
• Pediatric patients present unique physiological and clinical challenges necessitating tailored PBM strategies.
• Current pediatric PBM application is limited and inconsistent, highlighting a gap in evidence-based practice.

Purpose of the Study:

• To review current strategies for pediatric patient blood management (PBM).
• To explore future directions and advancements in PBM for pediatric populations.
• To emphasize the need for pediatric-specific research to standardize PBM protocols.

Main Methods:

• Literature review of current pediatric patient blood management (PBM) strategies.
• Analysis of recent studies on transfusion thresholds in pediatric populations.
• Exploration of emerging technologies and their potential impact on pediatric PBM.

Main Results:

• Key pediatric PBM elements include preserving red cell mass, managing anemia, minimizing blood loss, and optimizing transfusion practices.
• Restrictive transfusion thresholds are supported for critically ill children, neonates, and those with congenital heart disease.
• Liberal transfusion practices show no added benefit in these pediatric groups.

Conclusions:

• Pediatric patient blood management (PBM) requires tailored strategies addressing unique patient needs.
• Advances in precision medicine and AI may personalize pediatric transfusion practices.
• High-quality, pediatric-specific research is crucial for developing standardized, safe, and effective PBM protocols.