Impact of minimizing diagnostic blood loss in the critically ill

• Published in: Surgery 2015-10, Vol.158 (4), p.1083-1088
• Main Authors: Dolman, Heather S., MD, Evans, Kelly, C-NP, Zimmerman, Lisa Hall, PharmD, Lavery, Todd, MD, Baylor, Alfred E., MD, Wilson, Robert F., MD, Tyburski, James G., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anemia - etiology; Anemia - prevention & control; Critical Care - methods; Critical Illness; Erythrocyte Transfusion - statistics & numerical data; Female; Humans; Male; Middle Aged; Phlebotomy - adverse effects; Phlebotomy - instrumentation; Phlebotomy - statistics & numerical data; Retrospective Studies; Surgery; Treatment Outcome; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2015.05.018

Background The use of a small-volume phlebotomy tube (SVPT) versus conventional-volume phlebotomy tube (CVPT) has led to a decrease in daily blood loss. Blood loss due to phlebotomy can lead ultimately to decreased rates of anemia and blood transfusions, which can be important in the critically ill patient. Methods We compared SVPT vs CVPT retrospectively in critically ill adult patients age ≥18 years admitted to a surgical intensive care unit for ≥48 hours. CVPT were evaluated from January 2011 to May 2011 and SVPT from June 2012 to October 2012. Results Amount of blood drawn for laboratory tests and transfusions were evaluated in 248 patients (116 SVPT vs 132 CVPT). When compared with CVPT, total blood volume removed (mean ± SD) with SVPT was less overall, 174 ± 182 mL vs 299 ± 355 mL, P  = .001. Daily blood draws also were less, 22.5 ± 17.3 mL vs 31.7 ± 15.5 mL, P