Massive transfusion (peds)

This page is for pediatric patients; for adult patients see Massive transfusion

Indications

• Requiring > 40 mL/kg (40% blood volume) or 4 u for adult / patient > 30 kg over 2 hours or less
• Requiring or likely to require complete blood volume replacement or 10 u for adult in 24 hours

Age-specific blood volume

• Newborn – 1 month 90 mL/kg
• 1-12 months 85 mL/kg
• 1-14 years 80 mL/kg
• > 14 years 75 mL/kg
• Obese children 65 mL/kg

Procedure

Pediatric Massive Transfusion Protocol

MTP Pack 1	MTP Pack 2	MTP Pack 3	MTP Pack 4	MTP Pack 5
Children < 10 kg
25 mL/kg PRBC 20 mL/kg FFP call for platelets for pack 2	25 mL/kg PRBC 20 mL/kg FFP 10 mL/kg platelets	25 mL/kg PRBC 20 mL/kg FFP 10 mL/kg platelets 4 mL/kg cryoprecipitate	25 mL/kg PRBC 20 mL/kg FFP 10 mL/kg platelets 4 mL/kg cryoprecipitate	25 mL/kg PRBC 20 mL/kg FFP 10 mL/kg platelets 4 mL/kg cryoprecipitate
Children 10-20 kg
1u PRBC 1u FFP (thaw immediately after PRBC issued) call for platelets for pack 2	1u PRBC 1u FFP 1 platelet pack	1u PRBC 1u FFP 1 platelet pack 2.5u cryoprecipitate	1u PRBC 1u FFP 1 platelet pack 2.5u cryoprecipitate	1u PRBC 1u FFP 1 platelet pack 2.5u cryoprecipitate
Children 20-49 kg
2u PRBC 2u FFP call for platelets for pack 2	2u PRBC 2u FFP 1 platelet pack	2u PRBC 2u FFP 1 platelet pack 5u cryoprecipitate	2u PRBC 2u FFP 1 platelet pack 5u cryoprecipitate	2u PRBC 2u FFP 1 platelet pack 5u cryoprecipitate
Children > 50 kg
4u PRBC 4u FFP call for platelets for pack 2	4u PRBC 4u FFP 1 platelet pack	4u PRBC 4u FFP 1 platelet pack 10u cryoprecipitate	4u PRBC 4u FFP 1 platelet pack 10u cryoprecipitate	4u PRBC 4u FFP 1 platelet pack 10u cryoprecipitate