Thalassemia Patients and Friends
Discussion Forums => Thalassemia Major => Topic started by: pmeet on February 20, 2012, 07:32:17 PM
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Evi is now almost 11 months. She weighs 7.1Kg. Doctor has increased washed RBC from 100 ml to 105 ml. Is there any general guideline we can follow, something like X ml of washed RBC per G gram of weight?
Also doctor is advising us to only transfuse when it falls below 9. I have read different sources telling different Hg level to be maintained. Can someone please advise me.
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Dear pmeet,
The recommendation is to transfuse 14 - 16cc of blood per kg of body weight. For your baby that would be between 99.4 cc and 113.6cc.
Patient should be transfused when the hemoglobin is between 9.5 and 10.0. Doctors should not allow hemoglobin to fall below 9.5, it can interfere with growth (slowing down bone age), cause abnormal reticulocytes to form (which can lead to pulmonary hypertension), cause the body to absorb more iron from the gut, cause spleen to grow larger therefore increasing transfusion requirement, and harm the bones by causing them to expand. For all of the reasons and for your child's general feeling of well being - the guideline is to not allow the hemoglobin to fall too low (below 9 would be too low). It was once acceptable to allow the hemoglobin to fall below 9, doctors actually believed that it kept iron levels low - but over time doctors are realizing that the opposite is true.
Best of luck with Evi's transfusion. Feel free to ask us if you have any other questions.
Sharmin :hugfriend
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Pmeet,
for our daughter we have seen the doc following the rules as below...
if the Hgb before Tx is between 9 & 10, then she gets 15ml/Kg. = so, your child should get 105.
below 9, it is 20/Kg . that will be 140ml for your child.
We go for every 4 weeks Tx schedule and following the above rule, we have been able to hold our daughter's Hgb between 9 & 10 most of the times.