Patient: pediatric patient with malaria and anemia
Parameters:
(1) hemoglobin in g/dL (after resuscitation)
(2) respiratory distress (including deep and labored breathing)
(3) level of malaria transmission
|
Hemoglobin in g/dL
|
Respiratory Distress
|
Malaria Transmission
|
Transfuse?
|
|
<= 4 g/dL
|
NA
|
NA
|
Yes
|
|
4 - 5 g/dL
|
Yes
|
endemic
|
Yes
|
|
4 - 7 g/dL
|
Yes
|
non-endemic
|
Yes
|
where:
• A seriously ill patient who is dehydrated should be rehydrated prior to evaluation for transfusion.
• On page 143 of the WHO guidelines, the hemoglobin range for moderate to severe anemia is 4-5 g/dL while on page 191 it is 4-6 g/dL.
Additional reasons to consider transfusions in a patient with moderate to severe anemia (page 143):
(1) impaired consciousness
(2) shock
(3) heart failure
(4) high level parasitemia (> 10% of RBCs parasitized)
Transfusion is not recommended if the patient does not meet any of the above criteria.
All patients should receive effective anti-malarial therapy.
