Management of neonatal massive hemorrhage: A narrative review
Date
2026
Authors
Chooi, C.S.L.
Simmonds, M.C.
Fisher, L.
Crawford, T.
Stark, M.J.
Morris, S.
Brecht, M.
Taverner, F.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Transfusion, 2026; 1-11
Statement of Responsibility
Cheryl S. L. Chooi, Mary Claire Simmonds, Laura Fisher, Tara Crawford, Michael J. Stark, Scott Morris, Marcus Brecht, Fiona Taverner
Conference Name
Abstract
Massive hemorrhage in neonates is life-threatening, requiring prompt recognition and management, and multi-disciplinary teamwork to achieve best outcomes. A multi-center study of neonates admitted to neonatal intensive care (NICU) reported a 25% incidence of any episode of bleeding, 11% of which were categorized as major or severe. Neonates have distinct physiological differences which influence transfusion management; however, current evidence guiding management of massive hemorrhage in this high-risk population is limited. Current neonatal massive hemorrhage guidelines are adapted from weight-based pediatric and adult recommendations, with wide variation between institutions. This review encompasses neonatal physiology relevant to massive hemorrhage, management principles, and the current evidence, to inform evidence-based recommendations. Management of major hemorrhage during cardiac surgery is beyond the scope of this review.
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Dissertation Note
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OnlinePubl
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Rights
© 2026 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.