What is the common dose of packed red blood cells per kilogram in pediatric patients?

• A. 10-15 mL/kg per unit
• B. 5-7 mL/kg per unit
• C. 20-25 mL/kg per unit
• D. 1-2 mL/kg per unit

Answer: (A)

In pediatric transfusion practice, packed red blood cells are given by weight to achieve a reliable improvement in oxygen-carrying capacity while avoiding fluid overload. The standard single-unit dose for children is about 10 to 15 mL per kilogram of body weight. This means a child’s dose scales with size, so smaller children receive less total volume and larger children receive more, keeping the transfusion effective but not excessive. One unit of PRBC is typically around a few hundred milliliters, so a 20 kg child would receive roughly 200–300 mL when a full unit is given, aligned with that per-kilogram target.

If the dose were much lower (e.g., 5–7 mL/kg), the transfusion might not raise hemoglobin enough to improve tissue oxygen delivery. If it were much higher (e.g., 20–25 mL/kg), the child could experience fluid overload or heart-lung strain. The 10–15 mL/kg range reflects a balance between achieving a meaningful hematologic benefit and maintaining hemodynamic safety.