[Explanation and interpretation of blood transfusion provisions for critically ill and severely bleeding pediatric patients in the national health standard "Guideline for pediatric transfusion"]

Abstract

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Critically ill children often present with anemia and have a higher demand for transfusions compared to other pediatric patients. This guideline provides guidance and recommendations for blood transfusions in cases of general critical illness, septic shock, acute brain injury, extracorporeal membrane oxygenation, non-life-threatening bleeding, and hemorrhagic shock. This article interprets the background and evidence of the blood transfusion provisions for critically ill and severely bleeding children in the "Guideline for pediatric transfusion", aiming to enhance understanding and implementation of this aspect of the guidelines. Citation:Chinese Journal of Contemporary Pediatrics, 2025, 27(4): 395-403.

Keywords: Acute brain injury; Child; Critical illness; Extracorporeal membrane oxygenation; Hemorrhagic shock; Septic shock.

图1. 大量失血患儿（体重<50 kg）的输血方案示例 大量失血患儿除积极输血外，还需要注意其他治疗目标，如控制出血、体温保持正常或体温>35℃、Ca²⁺≥1 mmol/L、乳酸盐<1 mmol/L。[RBC］红细胞；［FFP］新鲜冰冻血浆；［PLT］血小板计数；［APTT］活化部分凝血活酶时间；［Fib］纤维蛋白原；［PT］凝血酶原时间；［RCPCH］英国皇家儿科与儿童健康学院。