Patient A a -year-old mal...

Patient A, a 3-year-old male, weighing 14 kg, presented with complaints of pallor and weakness since 2 weeks ago. Previously, the patient had received a blood transfusion last year due to anemia. Physical examination revealed slightly icteric sclera, enlarged liver 3 cm below arcus costae, 2 cm below processus xyphoideus, Schuffner 2 spleen.

Laboratory examination results: Hemoglobin 4.9 g/dL MCV 67.0 fL MCH 26 pg MCHC 27 g/dL The patient's cranial X-ray results are listed.

Diagnosis: Suspected thalassemia major or hypochromic microcytic anemia et causa suspected thalassemia major. 

Transfusion management:

- Hospitalization in intensive room/resuscitation room.

- Evaluate airway, breathing, circulation.

- Adequate nutrition intake according to RDA.

- Transfuse leukodepleted PRC, gradually every 12-24 hours, with a target hemoglobin of 12 g/dL. The first transfusion is given 5 mL/kg (80 mL), the next can be given 10 mL/kg (160 mL) 2 times, the distance between transfusions is about 12-24 hours. Total leukodepleted PRC transfusion needs 400 mL.

- Monitoring vital signs and transfusion reactions according to the transfusion monitoring record form (shortly before transfusion, 15 minutes after transfusion, at the completion of transfusion, and 4 hours after completion of transfusion).