WS/T 795-2022 in English

Analysis of standard framework and technological evolution

As the first dedicated specification for pediatric blood transfusion in my country, this standard integrates the clinical experience of 21 authoritative medical institutions and is formulated with reference to 8 international guidelines such as the British Society of Hematology. Compared with the adult blood transfusion standards, its innovation is reflected in:

Clinical interpretation of key terms

Transfusion thresholds: The guidelines clearly distinguish between strict (Hb <70g/L) and loose (Hb <100g/L) thresholds, for example:

• Stable aplastic anemia: strict threshold (Hb <70g/L)
• Complex cardiac surgery: loose threshold (Hb ≤100g/L)

Obvious bleeding: Refer to Appendix A WHO grading standards. Bleeding of grade 2 or above (such as persistent nose bleeding for >30min) meets the indications for transfusion.

Blood transfusion standards for special populations

Exchange transfusion technology for neonatal hemolytic disease

Operation points:

1. Blood combination: For ABO hemolytic disease, use O type red blood cells + AB type FFP
2. Exchange blood volume: 150-180mL/kg (2 times blood volume)
3. Fresh red blood cells <7 days old must be used

Blood transfusion for hematopoietic stem cell transplantation

During the blood type conversion period, the blood components must be selected according to Table 4. For ABO major-side incompatible transplants, O type red blood cells are given priority.

Implementation recommendations and risk control

Prevention of iatrogenic anemia

Recommendations for newborns:

• Use small-volume blood collection tubes (<1mL)
• Establish a blood loss record system

Handling of adverse reactions to blood transfusion

Key points for identifying latent reactions in children:

• Infants and young children: monitor respiratory rate and skin color changes
• Serum potassium and calcium should be rechecked within 24 hours after transfusion

Precautions for implementation of standards

1. Antigen matching files should be established for children with thalassemia (C/c/E/e)

2. Exchange transfusion operations require simultaneous monitoring:

• Record vital signs every 15 minutes
• Monitor blood sugar q1h