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Courtney Lawrence: The AABB Bulletin on Neonatal Red Blood Cell Transfusion and Mannitol Exposure is Now Released
Courtney Lawrence/LinkedIn
Jun 12, 2026, 15:16

Courtney Lawrence: The AABB Bulletin on Neonatal Red Blood Cell Transfusion and Mannitol Exposure is Now Released

Courtney Lawrence, Divisional Chief Medical Officer at the American Red Cross, shared a post on LinkedIn:

“The AABB Bulletin on Neonatal Red Blood Cell Transfusion and Mannitol Exposure is now released!

Key points:

  • Mannitol-containing RBC units are widely used globally and remain standard in many settings.
  • Evidence supports safety in routine small-volume neonatal transfusions (<20 mL/kg)..
  • For large-volume transfusions (>20 mL/kg), data are limited. Risk is not confirmed, but cannot be excluded, particularly with rapid transfusion or impaired patient renal function.
  • Potential clinical concerns (e.g., fluid shifts, electrolyte imbalance) are largely theoretical or extrapolated from therapeutic mannitol dosing, not transfusion-specific evidence.
  • Washing or volume reduction of red cell units may reduce exposure but come with other trade-offs (e.g., transfusion delays, RBC damage).

Take home:

  • Current evidence supports continued use of mannitol-containing RBCs for most neonatal transfusions, while emphasizing clinical judgment and caution in large-volume scenarios.
  • Urgent transfusions should not be delayed due to concerns about mannitol exposure.”

Courtney Lawrence: The AABB Bulletin on Neonatal Red Blood Cell Transfusion and Mannitol Exposure is Now Released

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