---
title: "Red Blood Cell (RBC) Transfusion Practices for Preterm and Term Infants in the NICU"
id: "pubmed-42674613"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674613"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674613/"
doi: "10.1542/neo.27-9-050"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Red Blood Cell (RBC) Transfusion Practices for Preterm and Term Infants in the NICU
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674613
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674613/)
- **DOI:** [10.1542/neo.27-9-050](https://doi.org/10.1542%2Fneo.27-9-050)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- **RBC transfusion** practices in neonatal intensive care units (NICUs) show substantial variability across clinicians and centers. - Determining which infants should receive transfusion and the optimal **hemoglobin** or **hematocrit** thresholds remains a persistent clinical challenge. - Well-conducted randomized controlled trials and short-term follow-up studies exist mainly for **premature** infants, providing a limited evidence base for that population. - Data on **term infants** are sparse; most guidance for term neonates comes from heterogeneous observational studies or broader pediatric critical care expert consensus rather than neonatal-specific trials. - The review summarizes current literature for both preterm and term infants, highlighting differences in evidence strength between groups. - It discusses patient-specific factors and comorbidities that influence transfusion decisions in critically ill infants. - Practical transfusion considerations covered include transfusion **volume**, **rate**, and blood product **preparation** when clinicians proceed with RBC transfusion. - The article also outlines strategies aimed at reducing the need for RBC transfusions in the NICU. - The authors present general strategies to guide the **neonatologist** in deciding when to transfuse, acknowledging gaps in high-quality data, especially for term infants. - Overall, the review emphasizes cautious, individualized decision-making and the need to balance available trial data for preterm infants with expert consensus and observational data for term infants.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Neonatal Intensive Care Unit, Pediatrics Department, Northridge Hospital Medical Center, Northridge, California. * 2 Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California. * PMID: **42674613** * DOI: [ 10.1542/neo.27-9-050 ](https://doi.org/10.1542/neo.27-9-050) Item in Clipboard Review # Red Blood Cell Transfusion for Preterm and Term Infants in the NICU Sheema Gaffar et al. Neoreviews. 2026. Show details Display options Display options Format Abstract PubMed PMID Neoreviews Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neoreviews%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neoreviews%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674613/) . 2026 Sep 1;27(9):e555-e570. doi: 10.1542/neo.27-9-050. ### Authors [Sheema Gaffar](https://pubmed.ncbi.nlm.nih.gov/?term=Gaffar+S&cauthor_id=42674613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674613/#short-view-affiliation-1 "Neonatal Intensive Care Unit, Pediatrics Department, Northridge Hospital Medical Center, Northridge, California."), [Molly Crimmins Easterlin](https://pubmed.ncbi.nlm.nih.gov/?term=Easterlin+MC&cauthor_id=42674613)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674613/#short-view-affiliation-2 "Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California.") ### Affiliations * 1 Neonatal Intensive Care Unit, Pediatrics Department, Northridge Hospital Medical Center, Northridge, California. * 2 Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California. * PMID: **42674613** * DOI: [ 10.1542/neo.27-9-050 ](https://doi.org/10.1542/neo.27-9-050) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Red blood cell (RBC) transfusion practices in neonatal intensive care units are variable. Determining which patients should be transfused, and the specific hemoglobin or hematocrit thresholds, remains a recurring challenge in neonatal intensive care. Although some well-conducted randomized controlled trials and short-term follow-up studies exist for premature infants, data on term infants remain limited. Most information on term infants is derived from heterogeneous observational studies or expert consensus guidelines intended for a wider pediatric critical care population. In this review, we summarize the current literature on RBC transfusions in preterm and term infants, discuss unique characteristics of critically ill infants with varying comorbidities, and provide general strategies to guide the neonatologist in deciding when to transfuse RBCs. We also review specific considerations during RBC transfusion, such as volume, rate, and preparation as well as strategies to decrease the need for RBC transfusions. Copyright © 2026 by the American Academy of Pediatrics. 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