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Patient blood management programs should be applied to the pediatric population, but little is known about the current transfusion practice of pediatric burn injury patients. This retrospective study was performed to evaluate the practice of red blood cell (RBC) transfusion in children with burn injury, their predictive factors, and adherence to the German transfusion guideline. We reviewed the RBC transfusion practice of all children younger than 8 years with burn injury who were operated during a four-year period in a German university