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Table 1 Summary of transfusion considerations in burned children

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 >20 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.