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.”
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