Choosing Wisely:

Don’t transfuse packed red blood cells for iron deficiency anemia in asymptomatic pediatric patients when there is no evidence of hemodynamic instability or active bleeding.

Rationale and Comments: In pediatric patients with asymptomatic, iron deficiency anemia, do not transfuse packed red blood cells in the absence of hemodynamic instability or active bleeding. Unnecessary packed red blood cell transfusions put patients at risk for complications, such as transfusion reactions, blood-borne infections, and volume overload. The judicious use of packed red blood cell transfusions would also be associated with cost savings for health care systems.
Sponsoring Organizations:
  • American Academy of Pediatrics – Section on Rheumatology
  • Sources:
  • Expert consensus
  • Disciplines:
  • Hematologic
  • Pediatric
  • References: • Alberta Medical Association. Iron Deficiency Anemia (IDA). 2018 Mar. Retrieved from actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/IDA-CPG.pdf.
    • British Columbia Guidelines and Protocols Advisory Committee. Iron deficiency – diagnosis and management. 2019 April. Retrieved from www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/iron-deficiency.

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