Blood Components and Their Uses in Pediatrics

Many blood products are available but they have never been safe as they can transmit diseases. For this reason children should only recieve blood products when othe conservative measures have failed.

Red Blood Cells ( RBCs )
Indicated in cases of severe anemia usually when Hb is < 7 gm%. or when there is acute , severe, traumatic blood loss.

Different types include:

• Whole Blood ( rarely used )
• Packed RBCs = whole blood less 70% of plasma , most commonly used
• Leukocyte poor RBCs= for pateints with history of febrile reaction to blood products or who will recieve many transfusions
• Washed RBCs = to prevent host-versus graft disease in Ig A deficient recipients

Platelets
Used when there is a potential for a clotting disorder due to thrombocytopenia ( platelets<10,000 or < 20,000 when surgery is planned ). indicated also in cases of clinically significant quantitative platelet defect.

Plasma
Available products include:

• Fresh frozen plsma (FFP )
• Single donor palsma

Indicated when there is an intravascular fluid depletion, not responsive to crystalloid or bleeding due to depletion of clotting factors.

Clotting Factor Concentrate

• Cryoprecipitate has high levels of factor VIII, von willebrand factor and fibrinogen
• Genetically Engineered factor VIII concentrates only for factor VIII defiecency.
• Vitamin K dependent factor concentrate has factors II, VII, IX, X and protein C and S

Indicated for factor deficiencies or acute liver failure .

Immune globulins
Non specific gamma globulins and intravenous gamma globulin (IVIG ) used in diseases like Guillain Barre or kawasaki disease.