Pediatric emergency medicine trisk 2180 2180

The stabilization of the severely anemic child is guided by the clinical
presentation more than by laboratory values. In chronic blood loss, low
hemoglobin levels may be relatively well tolerated due to compensatory
mechanisms and should not be the sole indication for transfusion.
The acuity or chronicity of a clinical condition will impact the clinical status
and thereby affect management. Prompt transfusions and isotonic fluid
resuscitation needed for acute blood loss may be detrimental in chronically
anemic patients.
Transfusion risks versus benefits must be considered based on the clinical
situation.

Current Evidence
Anemia in the pediatric patient ranges from an incidental finding in an asymptomatic
patient to acute or chronic processes presenting in a critically ill patient. The
classification of causes of anemia according to (i) blood loss, (ii) increased RBC
destruction, and (iii) decreased RBC production provides a framework for the evaluation
of the anemic child.