From: Children are not little adults: blood transfusion in children with burn injury
1. Despite a smaller stature, burned children have a greater body surface area per mass than adults. |
2. Cardiac function, mean blood volume, and normal hemoglobin levels are age-dependent in children; hence, children have a higher blood transfusion/unit volume ratio. |
3. The optimal hemoglobin threshold for initiating a blood transfusion in burned children has not yet been defined. |
4. Hyperkalemia associated with blood transfusion poses a significant risk in children, and potassium levels should be monitored in children receiving >20Â ml/kg transfusion volume. |
5. The maximal allowable blood loss (MABL), i.e., the volume of blood that can be lost in an operation without transfusing blood, can be calculated from the following (Hct = hematocrit, EBV = estimated blood volume): MABL = [(Hctstart − Hcttarget)/Hctstart] × EBV. |