a premature baby , gestational age 37 w , was planned for laser surgery due to ROP , weight was 1.4 kg .. no cardiac problem,,,,, chest is clinically free,,, oxygen saturation was 98 on room air ,,,, patient was not intubated ..... the problem was that he had physiological anaemia Hb = 8.3 .......neonatologists usually are not giving blood for such cases as it was physiological,,,,,the question is shall we proceed in such case with this Hb level as it is non bloody surgery ? or asking to raise the Hb level preoperatively due to our concern regarding oxygen carrying capacity?
Hi,
- Mature child tolerates Hct:20
- Premature, cyantotic kongenital heart disese, low O2 carrying capacity (Sickle cell e.t.) can tolerate Hct:30
- No one have formula to make decision
- I think baby do not need transfusion under this condition.
Dear Ashraf
I agree with the Dr Berrin. There is absolutely no need for blood transfusions for a non-bleeding surgical procedure. But of course it is a business that knows the Anesthesiologist.
I agree with the other answers, that didn't indicate a blood transfusio to this baby, as he isn't receiving any oxygen support and the surgery isn't bloody.
Though the anaesthesiologist raises alarm, one need not be panicky in dealing with this sort of situation since this is a chronic (anaemia) situation and baby can withstand nonbloody laser surgery. Proper analgesia during the procedure is the key for successful outcome of any procedure. Acute blood loss need to be replaced with fresh blood, if we want to do any emergency procedure.
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