Speed of Transfusion for children

Hello everyone!
Returning here after a long time. Hope everyone is doing well.

We recently moved to Phoenix...My daughter's 1st Tx in Phoenix Children's was yesterday. The speed of Tx was 150ml/hr. In Boston, it was 15ml/hr for 1st 15 mnts and after that the Tx rate is determine by the weight of the patient. For a 20kg child, it will be 5x20 = 100ml/hr. My daughter is only 4 and not sure if the high speed of Tx affects her heart. She was pretty cranky after the Tx. I am not sure if the higher speed of Tx has anything to do with it. Please suggest what is the right speed of Tx for children.

Hi Bostonian,

Will they follow the Standard of Care Guidelines for Thalassemia? It can be downloaded from our post at
http://www.thalassemiapatientsandfriends.com/index.php/topic,1762.msg14639.html#msg14639 
Is Boston willing to provide some guidelines for the new center to follow?

4.3.3 Target hemoglobin and frequency of
transfusions
...Blood should be transfused at 5 mL/kg per
hour, and the post-transfusion hemoglobin should not
exceed 14 g/dL.
In patients with severe anemia (hemoglobin less than 5
g/dL) or cardiac compromise, the rate of transfusion
should be reduced to 2 mL/kg per hour to avoid fluid
overload. Diuretics such as furosemide (1 to 2 mg/kg)
may be necessary for some patients.

Andy,

As always...you are so helpful....Thank you. I have to show this to the doc..

Thanks again...

The Standard of Care Guidelines for Thalassemia are recognized throughout the world and I recommend all parents and patients download a copy to their computers for reference purposes. These guidelines are key to proper management of thalassemia.

Bostonian, make sure the doctor is aware of your observations of your daughter concerning transfusion speed. You have seen both rates and their effects and are in a better position to form a judgment. There is a valid reason to go at the slower rate. The cumulative effect of transfusions on the heart is a negative for thals and reducing the physical stress on the heart during transfusions is essential. What may be OK for one who is getting a one time transfusion is not OK for one taking regular transfusions.